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This is VAERS ID 298501

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 298501
VAERS Form:
Age:0.2
Gender:Female
Location:Ohio
Vaccinated:2007-09-18
Onset:2007-11-19
Submitted:2007-12-03
Entered:2007-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHE: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS PAC21B097AB / 0 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF108AA / 0 LL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0875U / 0 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Barium enema abnormal, Computerised tomogram abnormal, Haematochezia, Intussusception

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations: extreme crying, high pitched crying~DTaP + HepB + IPV (Pediarix)~1~0~In Sibling1
Other Medications:
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: x-rays, CT scans, surgery
CDC 'Split Type': none

Write-up: 11/19/07 began with abd. pain and vomiting. taken to ER in Findlay in evening, discharged to home when vomiting ceased. symptoms continued that week and febrile suppositories given. on 11/24/07 taken to PCACC and xray, CT scan done. transferred to Toledo"Hospital and had surgery for intusseption.


Changed on 12/8/2009

VAERS ID: 298501 Before After
VAERS Form:
Age:0.2
Gender:Female
Location:Ohio
Vaccinated:2007-09-18
Onset:2007-11-19
Submitted:2007-12-03
Entered:2007-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHE: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS PAC21B097AB / 0 RL / IM
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS PAC21B097AB / 0 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF108AA / 0 LL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0875U / 0 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Barium enema abnormal, Computerised tomogram abnormal, Haematochezia, Intussusception, Laparoscopy, Mucous stools, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations: extreme crying, high pitched crying~DTaP + HepB + IPV (Pediarix)~1~0~In Sibling1 (Pediarix)~1~0.20~Sibling
Other Medications:
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: x-rays, CT scans, surgery 1/9/08-records received-CT abnormal. Barium enema unsuccessful attempt at reduction of intussusception at approximately the level of the distal ascending colon near the level of hepatic flexure.
CDC 'Split Type': none

Write-up: 11/19/07 began with abd. pain and vomiting. taken to ER in Findlay in evening, discharged to home when vomiting ceased. symptoms continued that week and febrile suppositories given. on 11/24/07 taken to PCACC and xray, CT scan done. transferred to Toledo"Hospital Hospital and had surgery for intusseption. 1/9/08-records received for DOS 11/24-11/28/07. DC DX: Intussusception. Laproscopic reduction of ileocolonic intussusception. Five days prior to admission developed abdominal pain and emesis. Bowel movement present with bloody mucus 2-3 days prior to admission.


Changed on 10/14/2012

VAERS ID: 298501 Before After
VAERS Form:
Age:0.2
Gender:Female
Location:Ohio
Vaccinated:2007-09-18
Onset:2007-11-19
Submitted:2007-12-03
Entered:2007-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS PAC21B097AB / 0 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF108AA / 0 LL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0875U / 0 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Barium enema abnormal, Computerised tomogram abnormal, Haematochezia, Intussusception, Laparoscopy, Mucous stools, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations: extreme crying, high pitched crying~DTaP + HepB + IPV (Pediarix)~1~0.20~Sibling
Other Medications:
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: x-rays, CT scans, surgery 1/9/08-records received-CT abnormal. Barium enema unsuccessful attempt at reduction of intussusception at approximately the level of the distal ascending colon near the level of hepatic flexure.
CDC 'Split Type': none (blank)

Write-up: 11/19/07 began with abd. pain and vomiting. taken to ER in Findlay in evening, discharged to home when vomiting ceased. symptoms continued that week and febrile suppositories given. on 11/24/07 taken to PCACC and xray, CT scan done. transferred to Hospital and had surgery for intusseption. 1/9/08-records received for DOS 11/24-11/28/07. DC DX: Intussusception. Laproscopic reduction of ileocolonic intussusception. Five days prior to admission developed abdominal pain and emesis. Bowel movement present with bloody mucus 2-3 days prior to admission.


Changed on 5/13/2013

VAERS ID: 298501 Before After
VAERS Form:
Age:0.2
Gender:Female
Location:Ohio
Vaccinated:2007-09-18
Onset:2007-11-19
Submitted:2007-12-03
Entered:2007-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS PAC21B097AB / 0 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF108AA / 0 LL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0875U / 0 - / PO
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0875U / 0 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Barium enema abnormal, Computerised tomogram abnormal, Haematochezia, Intussusception, Laparoscopy, Mucous stools, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations: extreme crying, high pitched crying~DTaP + HepB + IPV (Pediarix)~1~0.20~Sibling
Other Medications:
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: x-rays, CT scans, surgery 1/9/08-records received-CT abnormal. Barium enema unsuccessful attempt at reduction of intussusception at approximately the level of the distal ascending colon near the level of hepatic flexure.
CDC 'Split Type':

Write-up: 11/19/07 began with abd. pain and vomiting. taken to ER in Findlay in evening, discharged to home when vomiting ceased. symptoms continued that week and febrile suppositories given. on 11/24/07 taken to PCACC and xray, CT scan done. transferred to Hospital and had surgery for intusseption. 1/9/08-records received for DOS 11/24-11/28/07. DC DX: Intussusception. Laproscopic reduction of ileocolonic intussusception. Five days prior to admission developed abdominal pain and emesis. Bowel movement present with bloody mucus 2-3 days prior to admission.


Changed on 2/14/2017

VAERS ID: 298501 Before After
VAERS Form:
Age:0.2 0.18
Gender:Female
Location:Ohio
Vaccinated:2007-09-18
Onset:2007-11-19
Submitted:2007-12-03
Entered:2007-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS PAC21B097AB / 0 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF108AA / 0 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0875U / 0 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Barium enema abnormal, Computerised tomogram abnormal, Haematochezia, Intussusception, Laparoscopy, Mucous stools, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations: extreme crying, high pitched crying~DTaP + HepB + IPV (Pediarix)~1~0.20~Sibling
Other Medications:
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: x-rays, CT scans, surgery 1/9/08-records received-CT abnormal. Barium enema unsuccessful attempt at reduction of intussusception at approximately the level of the distal ascending colon near the level of hepatic flexure.
CDC 'Split Type':

Write-up: 11/19/07 began with abd. pain and vomiting. taken to ER in Findlay in evening, discharged to home when vomiting ceased. symptoms continued that week and febrile suppositories given. on 11/24/07 taken to PCACC and xray, CT scan done. transferred to Hospital and had surgery for intusseption. 1/9/08-records received for DOS 11/24-11/28/07. DC DX: Intussusception. Laproscopic reduction of ileocolonic intussusception. Five days prior to admission developed abdominal pain and emesis. Bowel movement present with bloody mucus 2-3 days prior to admission.


Changed on 4/14/2017

VAERS ID: 298501 Before After
VAERS Form:
Age:0.18
Gender:Female
Location:Ohio
Vaccinated:2007-09-18
Onset:2007-11-19
Submitted:2007-12-03
Entered:2007-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS PAC21B097AB / 0 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF108AA / 0 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0875U / 0 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Barium enema abnormal, Computerised tomogram abnormal, Haematochezia, Intussusception, Laparoscopy, Mucous stools, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations: extreme crying, high pitched crying~DTaP + HepB + IPV (Pediarix)~1~0.20~Sibling
Other Medications:
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: x-rays, CT scans, surgery 1/9/08-records received-CT abnormal. Barium enema unsuccessful attempt at reduction of intussusception at approximately the level of the distal ascending colon near the level of hepatic flexure.
CDC 'Split Type':

Write-up: 11/19/07 began with abd. pain and vomiting. taken to ER in Findlay in evening, discharged to home when vomiting ceased. symptoms continued that week and febrile suppositories given. on 11/24/07 taken to PCACC and xray, CT scan done. transferred to Hospital and had surgery for intusseption. 1/9/08-records received for DOS 11/24-11/28/07. DC DX: Intussusception. Laproscopic reduction of ileocolonic intussusception. Five days prior to admission developed abdominal pain and emesis. Bowel movement present with bloody mucus 2-3 days prior to admission.


Changed on 9/14/2017

VAERS ID: 298501 Before After
VAERS Form:(blank) 1
Age:0.18
Gender:Female
Location:Ohio
Vaccinated:2007-09-18
Onset:2007-11-19
Submitted:2007-12-03
Entered:2007-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS PAC21B097AB / 0 1 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF108AA / 0 1 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0875U / 0 1 - MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Intussusception, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations: extreme crying, high pitched crying~DTaP + HepB + IPV (Pediarix)~1~0.20~Sibling
Other Medications:
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: x-rays, CT scans, surgery 1/9/08-records received-CT abnormal. Barium enema unsuccessful attempt at reduction of intussusception at approximately the level of the distal ascending colon near the level of hepatic flexure.
CDC 'Split Type':

Write-up: 11/19/07 began with abd. pain and vomiting. taken to ER in Findlay in evening, discharged to home when vomiting ceased. symptoms continued that week and febrile suppositories given. on 11/24/07 taken to PCACC and xray, CT scan done. transferred to Hospital and had surgery for intusseption. 1/9/08-records received for DOS 11/24-11/28/07. DC DX: Intussusception. Laproscopic reduction of ileocolonic intussusception. Five days prior to admission developed abdominal pain and emesis. Bowel movement present with bloody mucus 2-3 days prior to admission.


Changed on 2/14/2018

VAERS ID: 298501 Before After
VAERS Form:1
Age:0.18
Gender:Female
Location:Ohio
Vaccinated:2007-09-18
Onset:2007-11-19
Submitted:2007-12-03
Entered:2007-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS PAC21B097AB / 1 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF108AA / 1 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0875U / 1 MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Intussusception, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations: extreme crying, high pitched crying~DTaP + HepB + IPV (Pediarix)~1~0.20~Sibling
Other Medications:
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: x-rays, CT scans, surgery 1/9/08-records received-CT abnormal. Barium enema unsuccessful attempt at reduction of intussusception at approximately the level of the distal ascending colon near the level of hepatic flexure.
CDC 'Split Type':

Write-up: 11/19/07 began with abd. pain and vomiting. taken to ER in Findlay in evening, discharged to home when vomiting ceased. symptoms continued that week and febrile suppositories given. on 11/24/07 taken to PCACC and xray, CT scan done. transferred to Hospital and had surgery for intusseption. 1/9/08-records received for DOS 11/24-11/28/07. DC DX: Intussusception. Laproscopic reduction of ileocolonic intussusception. Five days prior to admission developed abdominal pain and emesis. Bowel movement present with bloody mucus 2-3 days prior to admission.


Changed on 6/14/2018

VAERS ID: 298501 Before After
VAERS Form:1
Age:0.18
Gender:Female
Location:Ohio
Vaccinated:2007-09-18
Onset:2007-11-19
Submitted:2007-12-03
Entered:2007-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS PAC21B097AB / 1 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF108AA / 1 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0875U / 1 MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Intussusception, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations: extreme crying, high pitched crying~DTaP + HepB + IPV (Pediarix)~1~0.20~Sibling
Other Medications:
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: x-rays, CT scans, surgery 1/9/08-records received-CT abnormal. Barium enema unsuccessful attempt at reduction of intussusception at approximately the level of the distal ascending colon near the level of hepatic flexure.
CDC 'Split Type':

Write-up: 11/19/07 began with abd. pain and vomiting. taken to ER in Findlay in evening, discharged to home when vomiting ceased. symptoms continued that week and febrile suppositories given. on 11/24/07 taken to PCACC and xray, CT scan done. transferred to Hospital and had surgery for intusseption. 1/9/08-records received for DOS 11/24-11/28/07. DC DX: Intussusception. Laproscopic reduction of ileocolonic intussusception. Five days prior to admission developed abdominal pain and emesis. Bowel movement present with bloody mucus 2-3 days prior to admission.


Changed on 8/14/2018

VAERS ID: 298501 Before After
VAERS Form:1
Age:0.18
Gender:Female
Location:Ohio
Vaccinated:2007-09-18
Onset:2007-11-19
Submitted:2007-12-03
Entered:2007-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS PAC21B097AB / 1 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF108AA / 1 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0875U / 1 MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Intussusception, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations: extreme crying, high pitched crying~DTaP + HepB + IPV (Pediarix)~1~0.20~Sibling
Other Medications:
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: x-rays, CT scans, surgery 1/9/08-records received-CT abnormal. Barium enema unsuccessful attempt at reduction of intussusception at approximately the level of the distal ascending colon near the level of hepatic flexure.
CDC 'Split Type':

Write-up: 11/19/07 began with abd. pain and vomiting. taken to ER in Findlay in evening, discharged to home when vomiting ceased. symptoms continued that week and febrile suppositories given. on 11/24/07 taken to PCACC and xray, CT scan done. transferred to Hospital and had surgery for intusseption. 1/9/08-records received for DOS 11/24-11/28/07. DC DX: Intussusception. Laproscopic reduction of ileocolonic intussusception. Five days prior to admission developed abdominal pain and emesis. Bowel movement present with bloody mucus 2-3 days prior to admission.

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