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This is VAERS ID 524961

(NOTE: This result is from the 3/14/2015 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: None
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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http://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20150314&IDNUMBER=524961


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