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This is VAERS ID 547775

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

Case Details

VAERS ID: 547775 (history)  
Form: Version 1.0  
Age: 0.19  
Gender: Female  
Location: North Carolina  
Vaccinated:2014-08-12
Onset:2014-08-18
   Days after vaccination:6
Submitted: 2014-10-14
   Days after onset:57
Entered: 2014-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS 372DT / 1 RL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. J016187 / 1 LL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH H35553 / 1 LL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41CB425A / 1 MO / PO

Administered by: Private       Purchased by: Private
Symptoms: Enema administration, Intussusception, Pyrexia, Ultrasound scan, X-ray
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal obstruction (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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: Intussusception~Rotavirus (Rotarix)~1~0.17~Patient
Other Medications: None
Current Illness: NO
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data: Air enema reduction for intussusception x 3, xray and ultrasound done
CDC Split Type:

Write-up: Fever, intussusception, cefdinir given at office then changed to clindamycin during admission to hospital.


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Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20170914&IDNUMBER=547775


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