This is VAERS ID 528141

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

Case Details

VAERS ID:	528141 (history)
Form:	Version .0
Age:	0.2
Gender:	Female
Location:	Oklahoma

Vaccinated:	2014-03-24
Onset:	2014-03-29
Days after vaccination:	5
Submitted:	2014-04-10
Days after onset:	12
Entered:	2014-04-11
Days after submission:	1

Vaccination / Manufacturer	Lot / Dose	Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS	22J73 / 0	LL / UN
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC.	J013944 / 0	LL / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH	H06568 / 0	RL / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS	A41CB405A / 0	- / PO

Administered by: Public Purchased by: Public
Symptoms: Barium enema abnormal, Intussusception
SMQs:, Pseudomembranous colitis (broad), Gastrointestinal obstruction (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? Yes, 2 days
Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Radiology suite confirmed ileocolic intuss. via barium enema
CDC Split Type:

Write-up: Patient had routine 2-mo immunizations on 3/24/14 -$g admitted to hospital for intussusception on 3/29/14 and treated successfully via barium enema.

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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20140614&IDNUMBER=528141