This is VAERS ID 524961

(NOTE: This result is from the 6/14/2014 version of the VAERS database)

Case Details

VAERS ID:	524961 (history)
Form:	Version .0
Age:	0.2
Gender:	Female
Location:	Mississippi

Vaccinated:	2014-02-26
Onset:	2014-03-01
Days after vaccination:	3
Submitted:	2014-03-06
Days after onset:	5
Entered:	2014-03-06

Vaccination / Manufacturer	Lot / Dose	Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS	7537C / 0	- / -
HIBV: HIB (ACTHIB) / SANOFI PASTEUR	UH997AA / 0	- / -
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC.	H00137 / 0	- / -
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS	A41FB401A / 0	- / PO

Administered by: Private Purchased by: Public
Symptoms: Enema administration, Intussusception, Rash
SMQs:, Anaphylactic reaction (broad), Gastrointestinal obstruction (narrow), Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data: Done in ED
CDC Split Type:

Write-up: Intussusception 3/1 - 3/2/ 2014. Enema reduction. ? Rash on the face 24 hours after vaccine. Resolved in 2 days.

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Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20140614&IDNUMBER=524961