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This is VAERS ID 558082

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

Case Details

VAERS ID: 558082 (history)  
Form: Version .0  
Age: 0.23  
Gender: Female  
Location: Florida  
Vaccinated:2014-12-08
Onset:2014-12-08
   Days after vaccination:0
Submitted: 2014-12-12
   Days after onset:4
Entered: 2014-12-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS 232P5 / 0 RL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. K002935 / 0 LL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH J11486 / 0 LL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB452A / 0 - / PO

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: Drug withdrawal syndrome
Allergies:
Diagnostic Lab Data: U/S to diagnose
CDC Split Type:

Write-up: Now has ileo-ileo intussusception. Home today or tomorrow. Dx Abd U/S.


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Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20170214&IDNUMBER=558082


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