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This is VAERS ID 547899

(NOTE: This result is from the 10/14/2014 version of the VAERS database)

Case Details

VAERS ID: 547899 (history)  
Form: Version .0  
Age: 0.4  
Gender: Female  
Location: New York  
Vaccinated:2014-03-26
Onset:2014-09-14
   Days after vaccination:172
Submitted: 2014-10-14
   Days after onset:30
Entered: 2014-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR K11632 / 1 UN / UN
PPV: PNEUMO (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 UN / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41CB396A / 0 UN / UN

Administered by: Unknown       Purchased by: Private
Symptoms: Abdominal discomfort, Abdominal pain upper, Blood test, Gastroenteritis viral, Intussusception, Ultrasound scan, Vomiting, X-ray
SMQs:, Acute pancreatitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal obstruction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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, 1 days
   Extended hospital stay? No
Previous Vaccinations: intussusception~Rotavirus (Rotarix)~1~0.83~Patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Ultrasound, xrays, and bloodwork
CDC Split Type:

Write-up: Extreme cramping and belly discomfort in addition 4 bilious vomits and emergency treatment and admittance for intussusception on 9/15/2014. Second emergency room visit 10/02/2014 for viral gastroenteritis.


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Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20141014&IDNUMBER=547899


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