We analyze numerically the problem of spontaneous symmetry breaking and migration of a three-dimensional vesicle [a model for red blood cells (RBCs)] in axisymmetric Poiseuille flow. We explore the three relevant dimensionless parameters: (i) capillary number, Ca, measuring the ratio between the flow strength over the membrane bending mode, (ii) the ratio of viscosities of internal and external liquids, λ, and (iii) the reduced volume, ν=[V/(4/3)π]/(A/4π)3/2 (A and V are the area and volume of the vesicle). The overall picture turns out to be quite complex. We find that the parachute shape undergoes spontaneous symmetry-breaking bifurcations into a croissant shape and then into slipper shape. Regarding migration, we find complex scenarios depending on parameters: The vesicles either migrate towards the center, or migrate indefinitely away from it, or stop at some intermediate position. We also find coexisting solutions, in which the migration is inwards or outwards depending on the initial position. The revealed complexity can be exploited in the problem of cell sorting out and can help understanding the evolution of RBCs' in vivo circulation.