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This is VAERS ID 281426

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 281426
VAERS Form:
Age:0.3
Gender:Female
Location:Alabama
Vaccinated:2006-12-28
Onset:2007-01-29
Submitted:2007-06-12
Entered:2007-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER C2490AA5108 / 1 RL / IM
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER UF058AA11108 / 1 RL / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER Z03244108 / 1 LL / IM
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC B08470K12107 / 1 LL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0847F4108 / 1 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Barium double contrast, Diarrhoea, Intussusception, Fluid replacement

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Culturelle and a homeopathic antidiarrheal medication
Current Illness: Vomiting and diarrhea with some blood in the stool
Preexisting Conditions: None.
Allergies:
Diagnostic Lab Data: Air contrast enema (see above)
CDC 'Split Type':

Write-up: Was admitted to hospital 1/31/07 with abdomenal pain, vomiting and diarrhea. An air contrast enema during the hospitalization was felt to be consistent with intussusception. This resolved after the enema. The child received IV fluids and was subsequently"discharged home in good condition. 06/14/07-records received for DOS 01/37/07-Successful reduction of ileocolic intussusception by air enema. Presented to ER with vomiting and diarrhea. Diarrhea started 4 days ago. Loose stools some with blood in stool i


Changed on 12/8/2009

VAERS ID: 281426 Before After
VAERS Form:
Age:0.3
Gender:Female
Location:Alabama
Vaccinated:2006-12-28
Onset:2007-01-29
Submitted:2007-06-12
Entered:2007-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER C2490AA5108 / 1 RL / IM
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER UF058AA11108 / 1 RL / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER Z03244108 / 1 LL / IM
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC B08470K12107 / 1 LL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0847F4108 / 1 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Barium double contrast, Diarrhoea, Intussusception, Vomiting, Fluid replacement

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Culturelle and a homeopathic antidiarrheal medication
Current Illness: Vomiting and diarrhea with some blood in the stool
Preexisting Conditions: None.
Allergies:
Diagnostic Lab Data: Air contrast enema (see above)
CDC 'Split Type':

Write-up: Was admitted to hospital 1/31/07 with abdomenal pain, vomiting and diarrhea. An air contrast enema during the hospitalization was felt to be consistent with intussusception. This resolved after the enema. The child received IV fluids and was subsequently"discharged subsequently discharged home in good condition. 06/14/07-records received for DOS 01/37/07-Successful reduction of ileocolic intussusception by air enema. Presented to ER with vomiting and diarrhea. Diarrhea started 4 days ago. Loose stools some with blood in stool i initially but this has cleared. Nonbilious, nonbloody vomiting. Decreased PO Intake. Vaccination record received supports data submitted. No discharge summary dictated.


Changed on 3/2/2010

VAERS ID: 281426 Before After
VAERS Form:
Age:0.3
Gender:Female
Location:Alabama
Vaccinated:2006-12-28
Onset:2007-01-29
Submitted:2007-06-12
Entered:2007-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER C2490AA5108 / 1 RL / IM
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER UF058AA11108 / 1 RL / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER Z03244108 / 1 LL / IM
PNC: PNEUMO (PREVNAR) PNEUMO (PREVNAR7) / WYETH PHARMACEUTICALS, INC B08470K12107 / 1 LL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0847F4108 / 1 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Barium double contrast, Diarrhoea, Intussusception, Vomiting, Fluid replacement

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Culturelle and a homeopathic antidiarrheal medication
Current Illness: Vomiting and diarrhea with some blood in the stool
Preexisting Conditions: None.
Allergies:
Diagnostic Lab Data: Air contrast enema (see above)
CDC 'Split Type':

Write-up: Was admitted to hospital 1/31/07 with abdomenal pain, vomiting and diarrhea. An air contrast enema during the hospitalization was felt to be consistent with intussusception. This resolved after the enema. The child received IV fluids and was subsequently discharged home in good condition. 06/14/07-records received for DOS 01/37/07-Successful reduction of ileocolic intussusception by air enema. Presented to ER with vomiting and diarrhea. Diarrhea started 4 days ago. Loose stools some with blood in stool initially but this has cleared. Nonbilious, nonbloody vomiting. Decreased PO Intake. Vaccination record received supports data submitted. No discharge summary dictated.


Changed on 4/7/2010

VAERS ID: 281426 Before After
VAERS Form:
Age:0.3
Gender:Female
Location:Alabama
Vaccinated:2006-12-28
Onset:2007-01-29
Submitted:2007-06-12
Entered:2007-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER C2490AA5108 / 1 RL / IM
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER UF058AA11108 / 1 RL / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER Z03244108 / 1 LL / IM
PNC: PNEUMO (PREVNAR7) PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC B08470K12107 / 1 LL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0847F4108 / 1 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Barium double contrast, Diarrhoea, Intussusception, Vomiting, Fluid replacement

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Culturelle and a homeopathic antidiarrheal medication
Current Illness: Vomiting and diarrhea with some blood in the stool
Preexisting Conditions: None.
Allergies:
Diagnostic Lab Data: Air contrast enema (see above)
CDC 'Split Type':

Write-up: Was admitted to hospital 1/31/07 with abdomenal pain, vomiting and diarrhea. An air contrast enema during the hospitalization was felt to be consistent with intussusception. This resolved after the enema. The child received IV fluids and was subsequently discharged home in good condition. 06/14/07-records received for DOS 01/37/07-Successful reduction of ileocolic intussusception by air enema. Presented to ER with vomiting and diarrhea. Diarrhea started 4 days ago. Loose stools some with blood in stool initially but this has cleared. Nonbilious, nonbloody vomiting. Decreased PO Intake. Vaccination record received supports data submitted. No discharge summary dictated.


Changed on 8/31/2010

VAERS ID: 281426 Before After
VAERS Form:
Age:0.3
Gender:Female
Location:Alabama
Vaccinated:2006-12-28
Onset:2007-01-29
Submitted:2007-06-12
Entered:2007-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER C2490AA5108 / 1 RL / IM
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER UF058AA11108 / 1 RL / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER Z03244108 / 1 LL / IM
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH B08470K12107 / 1 LL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0847F4108 / 1 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Barium double contrast, Diarrhoea, Intussusception, Vomiting, Fluid replacement

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Culturelle and a homeopathic antidiarrheal medication
Current Illness: Vomiting and diarrhea with some blood in the stool
Preexisting Conditions: None.
Allergies:
Diagnostic Lab Data: Air contrast enema (see above)
CDC 'Split Type':

Write-up: Was admitted to hospital 1/31/07 with abdomenal pain, vomiting and diarrhea. An air contrast enema during the hospitalization was felt to be consistent with intussusception. This resolved after the enema. The child received IV fluids and was subsequently discharged home in good condition. 06/14/07-records received for DOS 01/37/07-Successful reduction of ileocolic intussusception by air enema. Presented to ER with vomiting and diarrhea. Diarrhea started 4 days ago. Loose stools some with blood in stool initially but this has cleared. Nonbilious, nonbloody vomiting. Decreased PO Intake. Vaccination record received supports data submitted. No discharge summary dictated.


Changed on 5/13/2013

VAERS ID: 281426 Before After
VAERS Form:
Age:0.3
Gender:Female
Location:Alabama
Vaccinated:2006-12-28
Onset:2007-01-29
Submitted:2007-06-12
Entered:2007-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER C2490AA5108 / 1 RL / IM
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER UF058AA11108 / 1 RL / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER Z03244108 / 1 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08470K12107 / 1 LL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0847F4108 / 1 - / PO
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0847F4108 / 1 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Barium double contrast, Diarrhoea, Intussusception, Vomiting, Fluid replacement

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Culturelle and a homeopathic antidiarrheal medication
Current Illness: Vomiting and diarrhea with some blood in the stool
Preexisting Conditions: None.
Allergies:
Diagnostic Lab Data: Air contrast enema (see above)
CDC 'Split Type':

Write-up: Was admitted to hospital 1/31/07 with abdomenal pain, vomiting and diarrhea. An air contrast enema during the hospitalization was felt to be consistent with intussusception. This resolved after the enema. The child received IV fluids and was subsequently discharged home in good condition. 06/14/07-records received for DOS 01/37/07-Successful reduction of ileocolic intussusception by air enema. Presented to ER with vomiting and diarrhea. Diarrhea started 4 days ago. Loose stools some with blood in stool initially but this has cleared. Nonbilious, nonbloody vomiting. Decreased PO Intake. Vaccination record received supports data submitted. No discharge summary dictated.


Changed on 9/14/2017

VAERS ID: 281426 Before After
VAERS Form:(blank) 1
Age:0.3
Gender:Female
Location:Alabama
Vaccinated:2006-12-28
Onset:2007-01-29
Submitted:2007-06-12
Entered:2007-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER C2490AA5108 / 1 2 RL / IM
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER UF058AA11108 / 1 2 RL / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER Z03244108 / 1 2 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08470K12107 / 1 2 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0847F4108 / 1 2 - MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Barium double contrast, Diarrhoea, Intussusception, Vomiting, Fluid replacement

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Culturelle and a homeopathic antidiarrheal medication
Current Illness: Vomiting and diarrhea with some blood in the stool
Preexisting Conditions: None.
Allergies:
Diagnostic Lab Data: Air contrast enema (see above)
CDC 'Split Type':

Write-up: Was admitted to hospital 1/31/07 with abdomenal pain, vomiting and diarrhea. An air contrast enema during the hospitalization was felt to be consistent with intussusception. This resolved after the enema. The child received IV fluids and was subsequently discharged home in good condition. 06/14/07-records received for DOS 01/37/07-Successful reduction of ileocolic intussusception by air enema. Presented to ER with vomiting and diarrhea. Diarrhea started 4 days ago. Loose stools some with blood in stool initially but this has cleared. Nonbilious, nonbloody vomiting. Decreased PO Intake. Vaccination record received supports data submitted. No discharge summary dictated.


Changed on 2/14/2018

VAERS ID: 281426 Before After
VAERS Form:1
Age:0.3
Gender:Female
Location:Alabama
Vaccinated:2006-12-28
Onset:2007-01-29
Submitted:2007-06-12
Entered:2007-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER C2490AA5108 / 2 RL / IM
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER UF058AA11108 / 2 RL / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER Z03244108 / 2 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08470K12107 / 2 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0847F4108 / 2 MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Barium double contrast, Diarrhoea, Intussusception, Vomiting, Fluid replacement

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Culturelle and a homeopathic antidiarrheal medication
Current Illness: Vomiting and diarrhea with some blood in the stool
Preexisting Conditions: None.
Allergies:
Diagnostic Lab Data: Air contrast enema (see above)
CDC 'Split Type':

Write-up: Was admitted to hospital 1/31/07 with abdomenal pain, vomiting and diarrhea. An air contrast enema during the hospitalization was felt to be consistent with intussusception. This resolved after the enema. The child received IV fluids and was subsequently discharged home in good condition. 06/14/07-records received for DOS 01/37/07-Successful reduction of ileocolic intussusception by air enema. Presented to ER with vomiting and diarrhea. Diarrhea started 4 days ago. Loose stools some with blood in stool initially but this has cleared. Nonbilious, nonbloody vomiting. Decreased PO Intake. Vaccination record received supports data submitted. No discharge summary dictated.


Changed on 6/14/2018

VAERS ID: 281426 Before After
VAERS Form:1
Age:0.3
Gender:Female
Location:Alabama
Vaccinated:2006-12-28
Onset:2007-01-29
Submitted:2007-06-12
Entered:2007-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER C2490AA5108 / 2 RL / IM
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER UF058AA11108 / 2 RL / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER Z03244108 / 2 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08470K12107 / 2 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0847F4108 / 2 MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Barium double contrast, Diarrhoea, Intussusception, Vomiting, Fluid replacement

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Culturelle and a homeopathic antidiarrheal medication
Current Illness: Vomiting and diarrhea with some blood in the stool
Preexisting Conditions: None.
Allergies:
Diagnostic Lab Data: Air contrast enema (see above)
CDC 'Split Type':

Write-up: Was admitted to hospital 1/31/07 with abdomenal pain, vomiting and diarrhea. An air contrast enema during the hospitalization was felt to be consistent with intussusception. This resolved after the enema. The child received IV fluids and was subsequently discharged home in good condition. 06/14/07-records received for DOS 01/37/07-Successful reduction of ileocolic intussusception by air enema. Presented to ER with vomiting and diarrhea. Diarrhea started 4 days ago. Loose stools some with blood in stool initially but this has cleared. Nonbilious, nonbloody vomiting. Decreased PO Intake. Vaccination record received supports data submitted. No discharge summary dictated.


Changed on 8/14/2018

VAERS ID: 281426 Before After
VAERS Form:1
Age:0.3
Gender:Female
Location:Alabama
Vaccinated:2006-12-28
Onset:2007-01-29
Submitted:2007-06-12
Entered:2007-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER C2490AA5108 / 2 RL / IM
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER UF058AA11108 / 2 RL / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER Z03244108 / 2 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08470K12107 / 2 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0847F4108 / 2 MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Barium double contrast, Diarrhoea, Intussusception, Vomiting, Fluid replacement

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Culturelle and a homeopathic antidiarrheal medication
Current Illness: Vomiting and diarrhea with some blood in the stool
Preexisting Conditions: None.
Allergies:
Diagnostic Lab Data: Air contrast enema (see above)
CDC 'Split Type':

Write-up: Was admitted to hospital 1/31/07 with abdomenal pain, vomiting and diarrhea. An air contrast enema during the hospitalization was felt to be consistent with intussusception. This resolved after the enema. The child received IV fluids and was subsequently discharged home in good condition. 06/14/07-records received for DOS 01/37/07-Successful reduction of ileocolic intussusception by air enema. Presented to ER with vomiting and diarrhea. Diarrhea started 4 days ago. Loose stools some with blood in stool initially but this has cleared. Nonbilious, nonbloody vomiting. Decreased PO Intake. Vaccination record received supports data submitted. No discharge summary dictated.

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