National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 375896

History of Changes from the VAERS Wayback Machine

First Appeared on 1/5/2010

VAERS ID: 375896
VAERS Form:
Age:0.3
Sex:Male
Location:Unknown
Vaccinated:2009-10-27
Onset:2009-12-16
Submitted:2009-12-28
Entered:2010-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3482AA / - UN / IM
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC D90888 / - UN / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0433Y / - - / PO

Administered by: Private      Purchased by: Private
Symptoms: Intussusception, Intestinal resection

Life Threatening? Yes
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? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Intussusception - Surgical reduction/resection of small piece of intestine.


Changed on 3/2/2010

VAERS ID: 375896 Before After
VAERS Form:
Age:0.3
Sex:Male
Location:Unknown
Vaccinated:2009-10-27
Onset:2009-12-16
Submitted:2009-12-28
Entered:2010-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3482AA / - UN / IM
PNC: PNEUMO (PREVNAR) PNEUMO (PREVNAR7) / WYETH PHARMACEUTICALS, INC D90888 / - UN / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0433Y / - - / PO

Administered by: Private      Purchased by: Private
Symptoms: Intussusception, Intestinal resection

Life Threatening? Yes
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? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Intussusception - Surgical reduction/resection of small piece of intestine.


Changed on 4/7/2010

VAERS ID: 375896 Before After
VAERS Form:
Age:0.3
Sex:Male
Location:Unknown
Vaccinated:2009-10-27
Onset:2009-12-16
Submitted:2009-12-28
Entered:2010-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3482AA / - UN / IM
PNC: PNEUMO (PREVNAR7) PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC D90888 / - UN / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0433Y / - - / PO

Administered by: Private      Purchased by: Private
Symptoms: Intussusception, Intestinal resection

Life Threatening? Yes
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? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Intussusception - Surgical reduction/resection of small piece of intestine.


Changed on 8/31/2010

VAERS ID: 375896 Before After
VAERS Form:
Age:0.3
Sex:Male
Location:Unknown
Vaccinated:2009-10-27
Onset:2009-12-16
Submitted:2009-12-28
Entered:2010-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3482AA / - UN / IM
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH D90888 / - UN / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0433Y / - - / PO

Administered by: Private      Purchased by: Private
Symptoms: Intussusception, Intestinal resection

Life Threatening? Yes
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? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Intussusception - Surgical reduction/resection of small piece of intestine.


Changed on 4/13/2011

VAERS ID: 375896 Before After
VAERS Form:
Age:0.3
Sex:Male
Location:Unknown
Vaccinated:2009-10-27
Onset:2009-12-16
Submitted:2009-12-28
Entered:2010-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3482AA / - UN / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH D90888 / - UN / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0433Y / - - / PO

Administered by: Private      Purchased by: Private
Symptoms: Intussusception, Nausea, Vomiting, X-ray abnormal, Intestinal resection

Life Threatening? Yes
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? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Intussusception - Surgical reduction/resection of small piece of intestine.


Changed on 5/13/2011

VAERS ID: 375896 Before After
VAERS Form:
Age:0.3
Sex:Male
Location:Unknown
Vaccinated:2009-10-27
Onset:2009-12-16
Submitted:2009-12-28
Entered:2010-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3482AA / - UN / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH D90888 / - UN / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0433Y / - - / PO

Administered by: Private      Purchased by: Private
Symptoms: Intussusception, Nausea, Vomiting, X-ray abnormal, Intestinal resection

Life Threatening? Yes
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? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Intussusception - Surgical reduction/resection of small piece of intestine.


Changed on 6/11/2011

VAERS ID: 375896 Before After
VAERS Form:
Age:0.3
Sex:Male
Location:Unknown
Vaccinated:2009-10-27
Onset:2009-12-16
Submitted:2009-12-28
Entered:2010-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3482AA / - UN / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH D90888 / - UN / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0433Y / - - / PO

Administered by: Private      Purchased by: Private
Symptoms: Intussusception, Nausea, Vomiting, X-ray abnormal, Intestinal resection

Life Threatening? Yes
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? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Intussusception - Surgical reduction/resection of small piece of intestine.


Changed on 5/13/2013

VAERS ID: 375896 Before After
VAERS Form:
Age:0.3
Sex:Male
Location:Unknown
Vaccinated:2009-10-27
Onset:2009-12-16
Submitted:2009-12-28
Entered:2010-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3482AA / - UN / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH D90888 / - UN / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0433Y / - - / PO
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0433Y / - - / PO

Administered by: Private      Purchased by: Private
Symptoms: Intussusception, Nausea, Vomiting, X-ray abnormal, Intestinal resection

Life Threatening? Yes
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? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Intussusception - Surgical reduction/resection of small piece of intestine.


Changed on 3/14/2015

VAERS ID: 375896 Before After
VAERS Form:
Age:0.3
Sex:Male
Location:Unknown
Vaccinated:2009-10-27
Onset:2009-12-16
Submitted:2009-12-28
Entered:2010-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3482AA / - UN / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH D90888 / - UN / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0433Y / - - / PO

Administered by: Private      Purchased by: Private
Symptoms: Intussusception, Nausea, Vomiting, X-ray abnormal, Intestinal resection

Life Threatening? Yes
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? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Intussusception - Surgical reduction/resection of small piece of intestine.


Changed on 2/14/2017

VAERS ID: 375896 Before After
VAERS Form:
Age:0.3 0.34
Sex:Male
Location:Unknown
Vaccinated:2009-10-27
Onset:2009-12-16
Submitted:2009-12-28
Entered:2010-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3482AA / - UN / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH D90888 / - UN / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0433Y / - - / PO

Administered by: Private      Purchased by: Private
Symptoms: Intussusception, Intestinal resection

Life Threatening? Yes
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? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Intussusception - Surgical reduction/resection of small piece of intestine.


Changed on 9/14/2017

VAERS ID: 375896 Before After
VAERS Form:(blank) 1
Age:0.34
Sex:Male
Location:Unknown
Vaccinated:2009-10-27
Onset:2009-12-16
Submitted:2009-12-28
Entered:2010-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3482AA / - UNK UN / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH D90888 / - UNK UN / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0433Y / - UNK - MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Intussusception, Intestinal resection

Life Threatening? Yes
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? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Intussusception - Surgical reduction/resection of small piece of intestine.


Changed on 2/14/2018

VAERS ID: 375896 Before After
VAERS Form:1
Age:0.34
Sex:Male
Location:Unknown
Vaccinated:2009-10-27
Onset:2009-12-16
Submitted:2009-12-28
Entered:2010-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3482AA / UNK UN / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH D90888 / UNK UN / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0433Y / UNK MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Intussusception, Intestinal resection

Life Threatening? Yes
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? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Intussusception - Surgical reduction/resection of small piece of intestine.


Changed on 6/14/2018

VAERS ID: 375896 Before After
VAERS Form:1
Age:0.34
Sex:Male
Location:Unknown
Vaccinated:2009-10-27
Onset:2009-12-16
Submitted:2009-12-28
Entered:2010-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3482AA / UNK UN / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH D90888 / UNK UN / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0433Y / UNK MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Intussusception, Intestinal resection

Life Threatening? Yes
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? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Intussusception - Surgical reduction/resection of small piece of intestine.


Changed on 8/14/2018

VAERS ID: 375896 Before After
VAERS Form:1
Age:0.34
Sex:Male
Location:Unknown
Vaccinated:2009-10-27
Onset:2009-12-16
Submitted:2009-12-28
Entered:2010-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3482AA / UNK UN / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH D90888 / UNK UN / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0433Y / UNK MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Intussusception, Intestinal resection

Life Threatening? Yes
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? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Intussusception - Surgical reduction/resection of small piece of intestine.


Changed on 9/14/2018

VAERS ID: 375896 Before After
VAERS Form:1
Age:0.34
Sex:Male
Location:Unknown
Vaccinated:2009-10-27
Onset:2009-12-16
Submitted:2009-12-28
Entered:2010-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3482AA / UNK UN / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH D90888 / UNK UN / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0433Y / UNK MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Intussusception, Intestinal resection

Life Threatening? Yes
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? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Intussusception - Surgical reduction/resection of small piece of intestine.


Changed on 10/14/2018

VAERS ID: 375896 Before After
VAERS Form:1
Age:0.34
Sex:Male
Location:Unknown
Vaccinated:2009-10-27
Onset:2009-12-16
Submitted:2009-12-28
Entered:2010-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3482AA / UNK UN / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH D90888 / UNK UN / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0433Y / UNK MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Intussusception, Intestinal resection

Life Threatening? Yes
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? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Intussusception - Surgical reduction/resection of small piece of intestine.

New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=375896&WAYBACKHISTORY=ON


Copyright © 2019 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166