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This is VAERS ID 527969

(NOTE: This result is from the 9/14/2017 version of the VAERS database)

Case Details

VAERS ID: 527969 (history)  
Form: Version 1.0  
Age: 0.17  
Gender: Female  
Location: Michigan  
Vaccinated:2014-02-25
Onset:2014-04-02
   Days after vaccination:36
Submitted: 2014-04-08
   Days after onset:6
Entered: 2014-04-09
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS 7449K / 1 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UH973AA / 1 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH G98652 / 1 RL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB414A / 1 MO / PO

Administered by: Private       Purchased by: Public
Symptoms: Diarrhoea haemorrhagic, Intussusception, Irritability, Surgery, Vomiting
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Pseudomembranous colitis (broad), Gastrointestinal obstruction (narrow), Gastrointestinal haemorrhage (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Ischaemic colitis (broad), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: TYLENOL
Current Illness:
Preexisting Conditions: Apnea; GERD; RSV Bronchitis
Allergies:
Diagnostic Lab Data: Intussusception / Surgery
CDC Split Type:

Write-up: Vomiting, bloody diarrhea, fussy.


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20170914&IDNUMBER=527969


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