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This is VAERS ID 382080

(NOTE: This result is from the 2/14/2018 version of the VAERS database)

Case Details

VAERS ID: 382080 (history)  
Form: Version 1.0  
Age: 0.35  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2010-03-02
Onset:2010-03-07
   Days after vaccination:5
Submitted: 2010-03-08
   Days after onset:1
Entered: 2010-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3570AA / 2 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH G25197 / 2 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1442Y / 2 MO / PO

Administered by: Unknown       Purchased by: Private
Symptoms: Blood test, Haematochezia, Intussusception, Rectal haemorrhage, Ultrasound scan
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal obstruction (narrow), Gastrointestinal haemorrhage (narrow), Ischaemic colitis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: BLOOD WORK, ULTRASOUNDS PERFORMED.
CDC Split Type:

Write-up: RECTAL BLEEDING/BLOOD IN STOOL. CHILD HOSPITALIZED WITH INTUSSUSCEPTION ON 3/7/2010.


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20180214&IDNUMBER=382080


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