National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 344235

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 344235
VAERS Form:
Age:0.2
Gender:Female
Location:New York
Vaccinated:2009-03-31
Onset:2009-04-13
Submitted:2009-04-15
Entered:2009-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B207AA / 0 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF513AA / 0 RL / IM
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC D33245 / 0 LL / IM
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FA697A / 0 - / PO

Administered by: Private      Purchased by: Private
Symptoms: Abdominal distension, Intussusception, Lethargy, Surgery, Vomiting, X-ray with contrast upper gastrointestinal tract, Anal haemorrhage, Enema administration, Exploratory operation, Computerised tomogram abdomen abnormal, Abdominal X-ray

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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Hospitalized 2/13/09; RSV; Bronchiolitis
Allergies:
Diagnostic Lab Data: Abdominal series; UGI; air contrast enema; exploratory surgery 5/14/09 hospital discharge summary recieved DOA 4/9/09-4/13/09. LABS and DIAGNOSTICS: Abdominal x-ray - dilated small bowel loops. Air contrast enema. CT scan of abdomen/pe
CDC 'Split Type':

Write-up: Pt. received vaccine 3/31/09. Presented with vomiting, lethargy on 4/14/09. Required surgery for Intussusception. 5/14/09 hospital discharge summary recieved DOA 4/9/09-4/13/09. FINAL DIAGNOSIS: Intussusception Post vaccination emesis, abdominal distention, lethargic, blood clots around anus.


Changed on 3/2/2010

VAERS ID: 344235 Before After
VAERS Form:
Age:0.2
Gender:Female
Location:New York
Vaccinated:2009-03-31
Onset:2009-04-13
Submitted:2009-04-15
Entered:2009-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B207AA / 0 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF513AA / 0 RL / IM
PNC: PNEUMO (PREVNAR) PNEUMO (PREVNAR7) / WYETH PHARMACEUTICALS, INC D33245 / 0 LL / IM
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FA697A / 0 - / PO

Administered by: Private      Purchased by: Private
Symptoms: Abdominal distension, Intussusception, Lethargy, Surgery, Vomiting, X-ray with contrast upper gastrointestinal tract, Anal haemorrhage, Enema administration, Exploratory operation, Computerised tomogram abdomen abnormal, Abdominal X-ray

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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Hospitalized 2/13/09; RSV; Bronchiolitis
Allergies:
Diagnostic Lab Data: Abdominal series; UGI; air contrast enema; exploratory surgery 5/14/09 hospital discharge summary recieved DOA 4/9/09-4/13/09. LABS and DIAGNOSTICS: Abdominal x-ray - dilated small bowel loops. Air contrast enema. CT scan of abdomen/pe
CDC 'Split Type':

Write-up: Pt. received vaccine 3/31/09. Presented with vomiting, lethargy on 4/14/09. Required surgery for Intussusception. 5/14/09 hospital discharge summary recieved DOA 4/9/09-4/13/09. FINAL DIAGNOSIS: Intussusception Post vaccination emesis, abdominal distention, lethargic, blood clots around anus.


Changed on 4/7/2010

VAERS ID: 344235 Before After
VAERS Form:
Age:0.2
Gender:Female
Location:New York
Vaccinated:2009-03-31
Onset:2009-04-13
Submitted:2009-04-15
Entered:2009-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B207AA / 0 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF513AA / 0 RL / IM
PNC: PNEUMO (PREVNAR7) PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC D33245 / 0 LL / IM
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FA697A / 0 - / PO

Administered by: Private      Purchased by: Private
Symptoms: Abdominal distension, Intussusception, Lethargy, Surgery, Vomiting, X-ray with contrast upper gastrointestinal tract, Anal haemorrhage, Enema administration, Exploratory operation, Computerised tomogram abdomen abnormal, Abdominal X-ray

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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Hospitalized 2/13/09; RSV; Bronchiolitis
Allergies:
Diagnostic Lab Data: Abdominal series; UGI; air contrast enema; exploratory surgery 5/14/09 hospital discharge summary recieved DOA 4/9/09-4/13/09. LABS and DIAGNOSTICS: Abdominal x-ray - dilated small bowel loops. Air contrast enema. CT scan of abdomen/pe
CDC 'Split Type':

Write-up: Pt. received vaccine 3/31/09. Presented with vomiting, lethargy on 4/14/09. Required surgery for Intussusception. 5/14/09 hospital discharge summary recieved DOA 4/9/09-4/13/09. FINAL DIAGNOSIS: Intussusception Post vaccination emesis, abdominal distention, lethargic, blood clots around anus.


Changed on 8/31/2010

VAERS ID: 344235 Before After
VAERS Form:
Age:0.2
Gender:Female
Location:New York
Vaccinated:2009-03-31
Onset:2009-04-13
Submitted:2009-04-15
Entered:2009-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B207AA / 0 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF513AA / 0 RL / IM
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH D33245 / 0 LL / IM
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FA697A / 0 - / PO

Administered by: Private      Purchased by: Private
Symptoms: Abdominal distension, Intussusception, Lethargy, Surgery, Vomiting, X-ray with contrast upper gastrointestinal tract, Anal haemorrhage, Enema administration, Exploratory operation, Computerised tomogram abdomen abnormal, Abdominal X-ray

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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Hospitalized 2/13/09; RSV; Bronchiolitis
Allergies:
Diagnostic Lab Data: Abdominal series; UGI; air contrast enema; exploratory surgery 5/14/09 hospital discharge summary recieved DOA 4/9/09-4/13/09. LABS and DIAGNOSTICS: Abdominal x-ray - dilated small bowel loops. Air contrast enema. CT scan of abdomen/pe
CDC 'Split Type':

Write-up: Pt. received vaccine 3/31/09. Presented with vomiting, lethargy on 4/14/09. Required surgery for Intussusception. 5/14/09 hospital discharge summary recieved DOA 4/9/09-4/13/09. FINAL DIAGNOSIS: Intussusception Post vaccination emesis, abdominal distention, lethargic, blood clots around anus.


Changed on 5/13/2013

VAERS ID: 344235 Before After
VAERS Form:
Age:0.2
Gender:Female
Location:New York
Vaccinated:2009-03-31
Onset:2009-04-13
Submitted:2009-04-15
Entered:2009-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B207AA / 0 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF513AA / 0 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH D33245 / 0 LL / IM
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FA697A / 0 - / PO
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FA697A / 0 - / PO

Administered by: Private      Purchased by: Private
Symptoms: Abdominal distension, Intussusception, Lethargy, Surgery, Vomiting, X-ray with contrast upper gastrointestinal tract, Anal haemorrhage, Enema administration, Exploratory operation, Computerised tomogram abdomen abnormal, Abdominal X-ray

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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Hospitalized 2/13/09; RSV; Bronchiolitis
Allergies:
Diagnostic Lab Data: Abdominal series; UGI; air contrast enema; exploratory surgery 5/14/09 hospital discharge summary recieved DOA 4/9/09-4/13/09. LABS and DIAGNOSTICS: Abdominal x-ray - dilated small bowel loops. Air contrast enema. CT scan of abdomen/pe
CDC 'Split Type':

Write-up: Pt. received vaccine 3/31/09. Presented with vomiting, lethargy on 4/14/09. Required surgery for Intussusception. 5/14/09 hospital discharge summary recieved DOA 4/9/09-4/13/09. FINAL DIAGNOSIS: Intussusception Post vaccination emesis, abdominal distention, lethargic, blood clots around anus.


Changed on 4/14/2017

VAERS ID: 344235 Before After
VAERS Form:
Age:0.2
Gender:Female
Location:New York
Vaccinated:2009-03-31
Onset:2009-04-13
Submitted:2009-04-15
Entered:2009-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B207AA / 0 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF513AA / 0 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH D33245 / 0 LL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FA697A / 0 - / PO

Administered by: Private      Purchased by: Private
Symptoms: Abdominal distension, Intussusception, Lethargy, Surgery, Vomiting, X-ray with contrast upper gastrointestinal tract, Anal haemorrhage, Enema administration, Exploratory operation, Computerised tomogram abdomen abnormal, Abdominal X-ray

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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Hospitalized 2/13/09; RSV; Bronchiolitis
Allergies:
Diagnostic Lab Data: Abdominal series; UGI; air contrast enema; exploratory surgery 5/14/09 hospital discharge summary recieved DOA 4/9/09-4/13/09. LABS and DIAGNOSTICS: Abdominal x-ray - dilated small bowel loops. Air contrast enema. CT scan of abdomen/pe abdomen/pelvis - thickened bowel and free fluid. Exploratory laparotomy - already reduced intussusception, ileocecal valve edematous.
CDC 'Split Type':

Write-up: Pt. received vaccine 3/31/09. Presented with vomiting, lethargy on 4/14/09. Required surgery for Intussusception. 5/14/09 hospital discharge summary recieved DOA 4/9/09-4/13/09. FINAL DIAGNOSIS: Intussusception Post vaccination emesis, abdominal distention, lethargic, blood clots around anus.


Changed on 9/14/2017

VAERS ID: 344235 Before After
VAERS Form:(blank) 1
Age:0.2
Gender:Female
Location:New York
Vaccinated:2009-03-31
Onset:2009-04-13
Submitted:2009-04-15
Entered:2009-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B207AA / 0 1 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF513AA / 0 1 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH D33245 / 0 1 LL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FA697A / 0 1 - MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Intussusception, Lethargy, Surgery, Vomiting, X-ray with contrast upper gastrointestinal tract, Enema administration, Exploratory operation, Abdominal X-ray

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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Hospitalized 2/13/09; RSV; Bronchiolitis
Allergies:
Diagnostic Lab Data: Abdominal series; UGI; air contrast enema; exploratory surgery 5/14/09 hospital discharge summary recieved DOA 4/9/09-4/13/09. LABS and DIAGNOSTICS: Abdominal x-ray - dilated small bowel loops. Air contrast enema. CT scan of abdomen/pelvis - thickened bowel and free fluid. Exploratory laparotomy - already reduced intussusception, ileocecal valve edematous.
CDC 'Split Type':

Write-up: Pt. received vaccine 3/31/09. Presented with vomiting, lethargy on 4/14/09. Required surgery for Intussusception. 5/14/09 hospital discharge summary recieved DOA 4/9/09-4/13/09. FINAL DIAGNOSIS: Intussusception Post vaccination emesis, abdominal distention, lethargic, blood clots around anus.


Changed on 2/14/2018

VAERS ID: 344235 Before After
VAERS Form:1
Age:0.2
Gender:Female
Location:New York
Vaccinated:2009-03-31
Onset:2009-04-13
Submitted:2009-04-15
Entered:2009-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B207AA / 1 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF513AA / 1 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH D33245 / 1 LL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FA697A / 1 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Intussusception, Lethargy, Surgery, Vomiting, X-ray with contrast upper gastrointestinal tract, Enema administration, Exploratory operation, Abdominal X-ray

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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Hospitalized 2/13/09; RSV; Bronchiolitis
Allergies:
Diagnostic Lab Data: Abdominal series; UGI; air contrast enema; exploratory surgery 5/14/09 hospital discharge summary recieved DOA 4/9/09-4/13/09. LABS and DIAGNOSTICS: Abdominal x-ray - dilated small bowel loops. Air contrast enema. CT scan of abdomen/pelvis - thickened bowel and free fluid. Exploratory laparotomy - already reduced intussusception, ileocecal valve edematous.
CDC 'Split Type':

Write-up: Pt. received vaccine 3/31/09. Presented with vomiting, lethargy on 4/14/09. Required surgery for Intussusception. 5/14/09 hospital discharge summary recieved DOA 4/9/09-4/13/09. FINAL DIAGNOSIS: Intussusception Post vaccination emesis, abdominal distention, lethargic, blood clots around anus.


Changed on 6/14/2018

VAERS ID: 344235 Before After
VAERS Form:1
Age:0.2
Gender:Female
Location:New York
Vaccinated:2009-03-31
Onset:2009-04-13
Submitted:2009-04-15
Entered:2009-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B207AA / 1 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF513AA / 1 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH D33245 / 1 LL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FA697A / 1 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Intussusception, Lethargy, Surgery, Vomiting, X-ray with contrast upper gastrointestinal tract, Enema administration, Exploratory operation, Abdominal X-ray

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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Hospitalized 2/13/09; RSV; Bronchiolitis
Allergies:
Diagnostic Lab Data: Abdominal series; UGI; air contrast enema; exploratory surgery 5/14/09 hospital discharge summary recieved DOA 4/9/09-4/13/09. LABS and DIAGNOSTICS: Abdominal x-ray - dilated small bowel loops. Air contrast enema. CT scan of abdomen/pelvis - thickened bowel and free fluid. Exploratory laparotomy - already reduced intussusception, ileocecal valve edematous.
CDC 'Split Type':

Write-up: Pt. received vaccine 3/31/09. Presented with vomiting, lethargy on 4/14/09. Required surgery for Intussusception. 5/14/09 hospital discharge summary recieved DOA 4/9/09-4/13/09. FINAL DIAGNOSIS: Intussusception Post vaccination emesis, abdominal distention, lethargic, blood clots around anus.


Changed on 8/14/2018

VAERS ID: 344235 Before After
VAERS Form:1
Age:0.2
Gender:Female
Location:New York
Vaccinated:2009-03-31
Onset:2009-04-13
Submitted:2009-04-15
Entered:2009-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B207AA / 1 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF513AA / 1 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH D33245 / 1 LL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FA697A / 1 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Intussusception, Lethargy, Surgery, Vomiting, X-ray with contrast upper gastrointestinal tract, Enema administration, Exploratory operation, Abdominal X-ray

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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Hospitalized 2/13/09; RSV; Bronchiolitis
Allergies:
Diagnostic Lab Data: Abdominal series; UGI; air contrast enema; exploratory surgery 5/14/09 hospital discharge summary recieved DOA 4/9/09-4/13/09. LABS and DIAGNOSTICS: Abdominal x-ray - dilated small bowel loops. Air contrast enema. CT scan of abdomen/pelvis - thickened bowel and free fluid. Exploratory laparotomy - already reduced intussusception, ileocecal valve edematous.
CDC 'Split Type':

Write-up: Pt. received vaccine 3/31/09. Presented with vomiting, lethargy on 4/14/09. Required surgery for Intussusception. 5/14/09 hospital discharge summary recieved DOA 4/9/09-4/13/09. FINAL DIAGNOSIS: Intussusception Post vaccination emesis, abdominal distention, lethargic, blood clots around anus.

New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=344235&WAYBACKHISTORY=ON


Copyright © 2018 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166