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This is VAERS ID 537517

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

Case Details

VAERS ID: 537517 (history)  
Form: Version .0  
Age: 0.18  
Gender: Female  
Location: California  
Vaccinated:2014-07-18
Onset:2014-07-21
   Days after vaccination:3
Submitted: 2014-07-23
   Days after onset:2
Entered: 2014-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS E2297 / 0 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UI097AA / 0 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH H45394 / 0 RL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB407A / 0 - / PO

Administered by: Public       Purchased by: Public
Symptoms: Enema administration, Intussusception, Ultrasound abdomen abnormal
SMQs:, Retroperitoneal fibrosis (broad), Gastrointestinal obstruction (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data: Ultrasound positive for intussusception and reduced via air enema.
CDC Split Type:

Write-up: Intussusception.


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20170214&IDNUMBER=537517


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