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This is VAERS ID 525493

(NOTE: This result is from the 2/14/2017 version of the VAERS database)

Case Details

VAERS ID: 525493 (history)  
Form: Version .0  
Age: 0.13  
Gender: Female  
Location: Florida  
Vaccinated:2014-02-26
Onset:2014-02-26
   Days after vaccination:0
Submitted: 2014-03-11
   Days after onset:12
Entered: 2014-03-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS 7449K / 0 LL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. J011112 / 0 LL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH G95397 / 0 RL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41CB389A / 0 - / PO

Administered by: Public       Purchased by: Public
Symptoms: Haematochezia, Intussusception, Milk allergy
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal obstruction (narrow), Gastrointestinal haemorrhage (narrow), Ischaemic colitis (broad)

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? No
Previous Vaccinations:
Other Medications: NA
Current Illness: No
Preexisting Conditions: Mother Hep B positive
Allergies:
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: Significant amount of bloody stool. Went to hospital and was dx with Milk Protein Allergy. PCP feels it was intussusception.


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20170214&IDNUMBER=525493


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