National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 531100

(NOTE: This result is from the 5/16/2014 version of the VAERS database)

Case Details

VAERS ID: 531100 (history)  
Form: Version .0  
Age: 0.3  
Gender: Male  
Location: Georgia  
Vaccinated:2014-04-24
Onset:2014-04-29
   Days after vaccination:5
Submitted: 2014-05-16
   Days after onset:17
Entered: 2014-05-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS ML5D7 / 1 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UH832AB / 1 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH H45098 / 1 LL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB412A / 1 - / PO

Administered by: Private       Purchased by: Private
Symptoms: Crying, Haematochezia, Intussusception
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal obstruction (narrow), Gastrointestinal haemorrhage (narrow), Ischaemic colitis (broad), Depression (excl suicide and self injury) (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Intussusception
CDC Split Type:

Write-up: Pt. mom states bloody stool, uncontrollable crying.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20140516&IDNUMBER=531100


Copyright © 2018 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166