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This is VAERS ID 522516

(NOTE: This result is from the 3/14/2014 version of the VAERS database)

Case Details

VAERS ID: 522516 (history)  
Form: Version .0  
Age: 0.3  
Gender: Female  
Location: California  
Vaccinated:2014-02-05
Onset:2014-02-09
   Days after vaccination:4
Submitted: 2014-02-12
   Days after onset:3
Entered: 2014-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS 7449K / - LL / UN
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UH976AA / - LL / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH G75064 / - RL / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41CB396A / 1 - / PO

Administered by: Private       Purchased by: Other
Symptoms: Barium enema, Enema administration, Intussusception, Ultrasound abdomen abnormal, Vomiting
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal obstruction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Abdmoinal ultrasound and barium enema
CDC Split Type:

Write-up: Patient was diagnosed with intussusception via abdominal ultrasound; she presented with billous vomiting for 2 days and was then admitted to Medical Center, where she was diagnosed by myself. While in the hospital she had a barium enema reduction of the intussusception that reduced the ailment without surgery. Patient was discharged the next day in stable condition. She was found to have the Rotavirus vaccine (as well as her other 2 month vaccines) given on 02/05/2014 by her PMD.


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