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This is VAERS ID 315531

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 315531
VAERS Form:
Age:0.3
Gender:Male
Location:Foreign
Vaccinated:2008-05-05
Onset:2008-05-10
Submitted:2008-06-06
Entered:2008-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC - / - UN / IM
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / - - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Barium enema, Intussusception, Ultrasound scan normal

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: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: Barium enema of opaque colon (results: quick filling of all the colic frame, which has a normal magnitude and structure. The valve passes well and 15 cm of terminal ileus. No existence of invagination.) and ultrasound scan (results: no find
CDC 'Split Type': ESWYEG01638908

Write-up: Information regarding PREVENAR was received from a healthcare professional via a regulatory authority regarding a 3-month-old male patient who experienced intussusception. The patient received a dose on 05-May-2008. The patient experienced intussusception on 10-May-2008. The patient was hospitalized. On 12-May-2008 the patient was spontaneously recovered. No additional information was available at the time of this report.


Changed on 3/2/2010

VAERS ID: 315531 Before After
VAERS Form:
Age:0.3
Gender:Male
Location:Foreign
Vaccinated:2008-05-05
Onset:2008-05-10
Submitted:2008-06-06
Entered:2008-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PNC: PNEUMO (PREVNAR) PNEUMO (PREVNAR7) / WYETH PHARMACEUTICALS, INC - / - UN / IM
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / - - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Barium enema, Intussusception, Ultrasound scan normal

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: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: Barium enema of opaque colon (results: quick filling of all the colic frame, which has a normal magnitude and structure. The valve passes well and 15 cm of terminal ileus. No existence of invagination.) and ultrasound scan (results: no find
CDC 'Split Type': ESWYEG01638908

Write-up: Information regarding PREVENAR was received from a healthcare professional via a regulatory authority regarding a 3-month-old male patient who experienced intussusception. The patient received a dose on 05-May-2008. The patient experienced intussusception on 10-May-2008. The patient was hospitalized. On 12-May-2008 the patient was spontaneously recovered. No additional information was available at the time of this report.


Changed on 4/7/2010

VAERS ID: 315531 Before After
VAERS Form:
Age:0.3
Gender:Male
Location:Foreign
Vaccinated:2008-05-05
Onset:2008-05-10
Submitted:2008-06-06
Entered:2008-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PNC: PNEUMO (PREVNAR7) PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC - / - UN / IM
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / - - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Barium enema, Intussusception, Ultrasound scan normal

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: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: Barium enema of opaque colon (results: quick filling of all the colic frame, which has a normal magnitude and structure. The valve passes well and 15 cm of terminal ileus. No existence of invagination.) and ultrasound scan (results: no find
CDC 'Split Type': ESWYEG01638908

Write-up: Information regarding PREVENAR was received from a healthcare professional via a regulatory authority regarding a 3-month-old male patient who experienced intussusception. The patient received a dose on 05-May-2008. The patient experienced intussusception on 10-May-2008. The patient was hospitalized. On 12-May-2008 the patient was spontaneously recovered. No additional information was available at the time of this report.


Changed on 8/31/2010

VAERS ID: 315531 Before After
VAERS Form:
Age:0.3
Gender:Male
Location:Foreign
Vaccinated:2008-05-05
Onset:2008-05-10
Submitted:2008-06-06
Entered:2008-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH - / - UN / IM
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / - - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Barium enema, Intussusception, Ultrasound scan normal

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: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: Barium enema of opaque colon (results: quick filling of all the colic frame, which has a normal magnitude and structure. The valve passes well and 15 cm of terminal ileus. No existence of invagination.) and ultrasound scan (results: no find
CDC 'Split Type': ESWYEG01638908

Write-up: Information regarding PREVENAR was received from a healthcare professional via a regulatory authority regarding a 3-month-old male patient who experienced intussusception. The patient received a dose on 05-May-2008. The patient experienced intussusception on 10-May-2008. The patient was hospitalized. On 12-May-2008 the patient was spontaneously recovered. No additional information was available at the time of this report.


Changed on 5/13/2013

VAERS ID: 315531 Before After
VAERS Form:
Age:0.3
Gender:Male
Location:Foreign
Vaccinated:2008-05-05
Onset:2008-05-10
Submitted:2008-06-06
Entered:2008-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH - / - UN / IM
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / - - / PO
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / - - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Barium enema, Intussusception, Ultrasound scan normal

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: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: Barium enema of opaque colon (results: quick filling of all the colic frame, which has a normal magnitude and structure. The valve passes well and 15 cm of terminal ileus. No existence of invagination.) and ultrasound scan (results: no find
CDC 'Split Type': ESWYEG01638908

Write-up: Information regarding PREVENAR was received from a healthcare professional via a regulatory authority regarding a 3-month-old male patient who experienced intussusception. The patient received a dose on 05-May-2008. The patient experienced intussusception on 10-May-2008. The patient was hospitalized. On 12-May-2008 the patient was spontaneously recovered. No additional information was available at the time of this report.


Changed on 4/14/2017

VAERS ID: 315531 Before After
VAERS Form:
Age:0.3
Gender:Male
Location:Foreign
Vaccinated:2008-05-05
Onset:2008-05-10
Submitted:2008-06-06
Entered:2008-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH - / - UN / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / - - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Barium enema, Intussusception, Ultrasound scan normal

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: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: Barium enema of opaque colon (results: quick filling of all the colic frame, which has a normal magnitude and structure. The valve passes well and 15 cm of terminal ileus. No existence of invagination.) and ultrasound scan (results: no find findings) were done on 12-May-2008.
CDC 'Split Type': ESWYEG01638908

Write-up: Information regarding PREVENAR was received from a healthcare professional via a regulatory authority regarding a 3-month-old male patient who experienced intussusception. The patient received a dose on 05-May-2008. The patient experienced intussusception on 10-May-2008. The patient was hospitalized. On 12-May-2008 the patient was spontaneously recovered. No additional information was available at the time of this report.


Changed on 9/14/2017

VAERS ID: 315531 Before After
VAERS Form:(blank) 1
Age:0.3
Gender:Male
Location:Foreign
Vaccinated:2008-05-05
Onset:2008-05-10
Submitted:2008-06-06
Entered:2008-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH - / - UNK UN / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / - UNK - MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Barium enema, Intussusception, Ultrasound scan normal

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: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: Barium enema of opaque colon (results: quick filling of all the colic frame, which has a normal magnitude and structure. The valve passes well and 15 cm of terminal ileus. No existence of invagination.) and ultrasound scan (results: no findings) were done on 12-May-2008.
CDC 'Split Type': ESWYEG01638908

Write-up: Information regarding PREVENAR was received from a healthcare professional via a regulatory authority regarding a 3-month-old male patient who experienced intussusception. The patient received a dose on 05-May-2008. The patient experienced intussusception on 10-May-2008. The patient was hospitalized. On 12-May-2008 the patient was spontaneously recovered. No additional information was available at the time of this report.


Changed on 2/14/2018

VAERS ID: 315531 Before After
VAERS Form:1
Age:0.3
Gender:Male
Location:Foreign
Vaccinated:2008-05-05
Onset:2008-05-10
Submitted:2008-06-06
Entered:2008-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH - / UNK UN / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Barium enema, Intussusception, Ultrasound scan normal

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: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: Barium enema of opaque colon (results: quick filling of all the colic frame, which has a normal magnitude and structure. The valve passes well and 15 cm of terminal ileus. No existence of invagination.) and ultrasound scan (results: no findings) were done on 12-May-2008.
CDC 'Split Type': ESWYEG01638908

Write-up: Information regarding PREVENAR was received from a healthcare professional via a regulatory authority regarding a 3-month-old male patient who experienced intussusception. The patient received a dose on 05-May-2008. The patient experienced intussusception on 10-May-2008. The patient was hospitalized. On 12-May-2008 the patient was spontaneously recovered. No additional information was available at the time of this report.


Changed on 6/14/2018

VAERS ID: 315531 Before After
VAERS Form:1
Age:0.3
Gender:Male
Location:Foreign
Vaccinated:2008-05-05
Onset:2008-05-10
Submitted:2008-06-06
Entered:2008-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH - / UNK UN / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Barium enema, Intussusception, Ultrasound scan normal

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: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: Barium enema of opaque colon (results: quick filling of all the colic frame, which has a normal magnitude and structure. The valve passes well and 15 cm of terminal ileus. No existence of invagination.) and ultrasound scan (results: no findings) were done on 12-May-2008.
CDC 'Split Type': ESWYEG01638908

Write-up: Information regarding PREVENAR was received from a healthcare professional via a regulatory authority regarding a 3-month-old male patient who experienced intussusception. The patient received a dose on 05-May-2008. The patient experienced intussusception on 10-May-2008. The patient was hospitalized. On 12-May-2008 the patient was spontaneously recovered. No additional information was available at the time of this report.


Changed on 8/14/2018

VAERS ID: 315531 Before After
VAERS Form:1
Age:0.3
Gender:Male
Location:Foreign
Vaccinated:2008-05-05
Onset:2008-05-10
Submitted:2008-06-06
Entered:2008-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH - / UNK UN / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Barium enema, Intussusception, Ultrasound scan normal

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: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: Barium enema of opaque colon (results: quick filling of all the colic frame, which has a normal magnitude and structure. The valve passes well and 15 cm of terminal ileus. No existence of invagination.) and ultrasound scan (results: no findings) were done on 12-May-2008.
CDC 'Split Type': ESWYEG01638908

Write-up: Information regarding PREVENAR was received from a healthcare professional via a regulatory authority regarding a 3-month-old male patient who experienced intussusception. The patient received a dose on 05-May-2008. The patient experienced intussusception on 10-May-2008. The patient was hospitalized. On 12-May-2008 the patient was spontaneously recovered. No additional information was available at the time of this report.


Changed on 9/14/2018

VAERS ID: 315531 Before After
VAERS Form:1
Age:0.3
Gender:Male
Location:Foreign
Vaccinated:2008-05-05
Onset:2008-05-10
Submitted:2008-06-06
Entered:2008-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH - / UNK UN / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Barium enema, Intussusception, Ultrasound scan normal

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: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: Barium enema of opaque colon (results: quick filling of all the colic frame, which has a normal magnitude and structure. The valve passes well and 15 cm of terminal ileus. No existence of invagination.) and ultrasound scan (results: no findings) were done on 12-May-2008.
CDC 'Split Type': ESWYEG01638908

Write-up: Information regarding PREVENAR was received from a healthcare professional via a regulatory authority regarding a 3-month-old male patient who experienced intussusception. The patient received a dose on 05-May-2008. The patient experienced intussusception on 10-May-2008. The patient was hospitalized. On 12-May-2008 the patient was spontaneously recovered. No additional information was available at the time of this report.

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