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This is VAERS ID 378753

History of Changes from the VAERS Wayback Machine

First Appeared on 2/5/2010

VAERS ID: 378753
VAERS Form:
Age:0.5
Gender:Male
Location:Connecticut
Vaccinated:2010-01-20
Onset:2010-01-23
Submitted:2010-01-27
Entered:2010-01-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVB762CA / 1 RL / UN
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FA963A / 1 - / PO

Administered by: Private      Purchased by: Private
Symptoms: Abdominal pain upper, 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: 1     Extended hospital stay? No
Previous Vaccinations: Vomiting, abd pain~Rotavirus (Rotarix)~1~0.00~Patient
Other Medications:
Current Illness: None
Preexisting Conditions: Murmur.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': Murmur.

Write-up: 12/16/09 ROTARIX #1-developed belly pain and vomiting. 1/20/10 ROTARIX #2-on 1/23/10 intussusception.


Changed on 4/7/2010

VAERS ID: 378753 Before After
VAERS Form:
Age:0.5
Gender:Male
Location:Connecticut
Vaccinated:2010-01-20
Onset:2010-01-23
Submitted:2010-01-27
Entered:2010-01-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVB762CA / 1 RL / UN
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FA963A / 1 - / PO

Administered by: Private      Purchased by: Private
Symptoms: Abdominal pain upper, Blood albumin increased, Blood creatinine decreased, Crying, Haematochezia, Intussusception, Irritability, Lymphocyte count decreased, Mucous stools, Neutrophil count increased, Screaming, Vomiting, White blood cell count increased, X-ray normal, Platelet count increased, Ultrasound abdomen normal, Blood alkaline phosphatase increased

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: 1     Extended hospital stay? No
Previous Vaccinations: Vomiting, abd pain~Rotavirus (Rotarix)~1~0.00~Patient
Other Medications:
Current Illness: None
Preexisting Conditions: Murmur.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': Murmur.

Write-up: 12/16/09 ROTARIX #1-developed belly pain and vomiting. 1/20/10 ROTARIX #2-on 1/23/10 intussusception.


Changed on 7/31/2010

VAERS ID: 378753 Before After
VAERS Form:
Age:0.5
Gender:Male
Location:Connecticut
Vaccinated:2010-01-20
Onset:2010-01-23
Submitted:2010-01-27
Entered:2010-01-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVB762CA / 1 RL / UN
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FA963A / 1 - / PO

Administered by: Private      Purchased by: Private
Symptoms: Abdominal pain upper, Blood albumin increased, Blood creatinine decreased, Crying, Haematochezia, Intussusception, Irritability, Lymphocyte count decreased, Mucous stools, Neutrophil count increased, Screaming, Vomiting, White blood cell count increased, X-ray normal, Platelet count increased, Ultrasound abdomen normal, Blood alkaline phosphatase increased

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: 1     Extended hospital stay? No
Previous Vaccinations: Vomiting, abd pain~Rotavirus (Rotarix)~1~0.00~Patient
Other Medications:
Current Illness: None
Preexisting Conditions: Murmur.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': Murmur.

Write-up: 12/16/09 ROTARIX #1-developed belly pain and vomiting. 1/20/10 ROTARIX #2-on 1/23/10 intussusception.


Changed on 4/13/2011

VAERS ID: 378753 Before After
VAERS Form:
Age:0.5
Gender:Male
Location:Connecticut
Vaccinated:2010-01-20
Onset:2010-01-23
Submitted:2010-01-27
Entered:2010-01-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVB762CA / 1 RL / UN
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FA963A / 1 - / PO

Administered by: Private      Purchased by: Private
Symptoms: Abdominal pain upper, Blood albumin increased, Blood creatinine decreased, Crying, Haematochezia, Intussusception, Irritability, Lymphocyte count decreased, Mucous stools, Neutrophil count increased, Screaming, Vomiting, White blood cell count increased, X-ray normal, Platelet count increased, Ultrasound abdomen normal, Blood alkaline phosphatase increased, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: Vomiting, abd pain~Rotavirus (Rotarix)~1~0.00~Patient
Other Medications:
Current Illness: None
Preexisting Conditions: Murmur.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': Murmur.

Write-up: 12/16/09 ROTARIX #1-developed belly pain and vomiting. 1/20/10 ROTARIX #2-on 1/23/10 intussusception.


Changed on 5/13/2011

VAERS ID: 378753 Before After
VAERS Form:
Age:0.5
Gender:Male
Location:Connecticut
Vaccinated:2010-01-20
Onset:2010-01-23
Submitted:2010-01-27
Entered:2010-01-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVB762CA / 1 RL / UN
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FA963A / 1 - / PO

Administered by: Private      Purchased by: Private
Symptoms: Abdominal pain upper, Blood albumin increased, Blood creatinine decreased, Crying, Haematochezia, Intussusception, Irritability, Lymphocyte count decreased, Mucous stools, Neutrophil count increased, Screaming, Vomiting, White blood cell count increased, X-ray normal, Platelet count increased, Ultrasound abdomen normal, Blood alkaline phosphatase increased, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: Vomiting, abd pain~Rotavirus (Rotarix)~1~0.00~Patient
Other Medications:
Current Illness: None
Preexisting Conditions: Murmur.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': Murmur.

Write-up: 12/16/09 ROTARIX #1-developed belly pain and vomiting. 1/20/10 ROTARIX #2-on 1/23/10 intussusception.


Changed on 6/11/2011

VAERS ID: 378753 Before After
VAERS Form:
Age:0.5
Gender:Male
Location:Connecticut
Vaccinated:2010-01-20
Onset:2010-01-23
Submitted:2010-01-27
Entered:2010-01-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVB762CA / 1 RL / UN
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FA963A / 1 - / PO

Administered by: Private      Purchased by: Private
Symptoms: Abdominal pain upper, Blood albumin increased, Blood creatinine decreased, Crying, Haematochezia, Intussusception, Irritability, Lymphocyte count decreased, Mucous stools, Neutrophil count increased, Screaming, Vomiting, White blood cell count increased, X-ray normal, Platelet count increased, Ultrasound abdomen normal, Blood alkaline phosphatase increased, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: Vomiting, abd pain~Rotavirus (Rotarix)~1~0.00~Patient
Other Medications:
Current Illness: None
Preexisting Conditions: Murmur.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': Murmur.

Write-up: 12/16/09 ROTARIX #1-developed belly pain and vomiting. 1/20/10 ROTARIX #2-on 1/23/10 intussusception.


Changed on 10/14/2012

VAERS ID: 378753 Before After
VAERS Form:
Age:0.5
Gender:Male
Location:Connecticut
Vaccinated:2010-01-20
Onset:2010-01-23
Submitted:2010-01-27
Entered:2010-01-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVB762CA / 1 RL / UN
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FA963A / 1 - / PO

Administered by: Private      Purchased by: Private
Symptoms: Abdominal pain upper, Blood albumin increased, Blood creatinine decreased, Crying, Haematochezia, Intussusception, Irritability, Lymphocyte count decreased, Mucous stools, Neutrophil count increased, Screaming, Vomiting, White blood cell count increased, X-ray normal, Platelet count increased, Ultrasound abdomen normal, Blood alkaline phosphatase increased, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: Vomiting, abd pain~Rotavirus (Rotarix)~1~0.00~Patient
Other Medications:
Current Illness: None
Preexisting Conditions: Murmur.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': Murmur. (blank)

Write-up: 12/16/09 ROTARIX #1-developed belly pain and vomiting. 1/20/10 ROTARIX #2-on 1/23/10 intussusception.


Changed on 5/13/2013

VAERS ID: 378753 Before After
VAERS Form:
Age:0.5
Gender:Male
Location:Connecticut
Vaccinated:2010-01-20
Onset:2010-01-23
Submitted:2010-01-27
Entered:2010-01-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVB762CA / 1 RL / UN
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FA963A / 1 - / PO
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FA963A / 1 - / PO

Administered by: Private      Purchased by: Private
Symptoms: Abdominal pain upper, Blood albumin increased, Blood creatinine decreased, Crying, Haematochezia, Intussusception, Irritability, Lymphocyte count decreased, Mucous stools, Neutrophil count increased, Screaming, Vomiting, White blood cell count increased, X-ray normal, Platelet count increased, Ultrasound abdomen normal, Blood alkaline phosphatase increased, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: Vomiting, abd pain~Rotavirus (Rotarix)~1~0.00~Patient
Other Medications:
Current Illness: None
Preexisting Conditions: Murmur.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 12/16/09 ROTARIX #1-developed belly pain and vomiting. 1/20/10 ROTARIX #2-on 1/23/10 intussusception.


Changed on 6/14/2014

VAERS ID: 378753 Before After
VAERS Form:
Age:0.5
Gender:Male
Location:Connecticut
Vaccinated:2010-01-20
Onset:2010-01-23
Submitted:2010-01-27
Entered:2010-01-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVB762CA / 1 RL / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FA963A / 1 - / PO

Administered by: Private      Purchased by: Private
Symptoms: Abdominal pain upper, Blood albumin increased, Blood creatinine decreased, Crying, Haematochezia, Intussusception, Irritability, Lymphocyte count decreased, Mucous stools, Neutrophil count increased, Screaming, Vomiting, White blood cell count increased, X-ray normal, Platelet count increased, Ultrasound abdomen normal, Blood alkaline phosphatase increased, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: Vomiting, abd pain~Rotavirus (Rotarix)~1~0.00~Patient
Other Medications:
Current Illness: None
Preexisting Conditions: Murmur.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 12/16/09 ROTARIX #1-developed belly pain and vomiting. 1/20/10 ROTARIX #2-on 1/23/10 intussusception.


Changed on 3/14/2015

VAERS ID: 378753 Before After
VAERS Form:
Age:0.5
Gender:Male
Location:Connecticut
Vaccinated:2010-01-20
Onset:2010-01-23
Submitted:2010-01-27
Entered:2010-01-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVB762CA / 1 RL / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FA963A / 1 - / PO

Administered by: Private      Purchased by: Private
Symptoms: Abdominal pain upper, Blood albumin increased, Blood creatinine decreased, Crying, Haematochezia, Intussusception, Irritability, Lymphocyte count decreased, Mucous stools, Neutrophil count increased, Screaming, Vomiting, White blood cell count increased, X-ray normal, Platelet count increased, Ultrasound abdomen normal, Blood alkaline phosphatase increased, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Murmur.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 12/16/09 ROTARIX #1-developed belly pain and vomiting. 1/20/10 ROTARIX #2-on 1/23/10 intussusception.


Changed on 2/14/2017

VAERS ID: 378753 Before After
VAERS Form:
Age:0.5 0.45
Gender:Male
Location:Connecticut
Vaccinated:2010-01-20
Onset:2010-01-23
Submitted:2010-01-27
Entered:2010-01-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVB762CA / 1 RL / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FA963A / 1 - / PO

Administered by: Private      Purchased by: Private
Symptoms: Abdominal pain upper, 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: 1     Extended hospital stay? No
Previous Vaccinations: Vomiting, abd pain~Rotavirus (Rotarix)~1~0.00~Patient
Other Medications:
Current Illness: None
Preexisting Conditions: Murmur.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 12/16/09 ROTARIX #1-developed belly pain and vomiting. 1/20/10 ROTARIX #2-on 1/23/10 intussusception.


Changed on 9/14/2017

VAERS ID: 378753 Before After
VAERS Form:(blank) 1
Age:0.45
Gender:Male
Location:Connecticut
Vaccinated:2010-01-20
Onset:2010-01-23
Submitted:2010-01-27
Entered:2010-01-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVB762CA / 1 2 RL / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FA963A / 1 2 - MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Abdominal pain upper, 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: 1     Extended hospital stay? No
Previous Vaccinations: Vomiting, abd pain~Rotavirus (Rotarix)~1~0.00~Patient
Other Medications:
Current Illness: None
Preexisting Conditions: Murmur.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 12/16/09 ROTARIX #1-developed belly pain and vomiting. 1/20/10 ROTARIX #2-on 1/23/10 intussusception.


Changed on 2/14/2018

VAERS ID: 378753 Before After
VAERS Form:1
Age:0.45
Gender:Male
Location:Connecticut
Vaccinated:2010-01-20
Onset:2010-01-23
Submitted:2010-01-27
Entered:2010-01-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVB762CA / 2 RL / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FA963A / 2 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Abdominal pain upper, 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: 1     Extended hospital stay? No
Previous Vaccinations: Vomiting, abd pain~Rotavirus (Rotarix)~1~0.00~Patient
Other Medications:
Current Illness: None
Preexisting Conditions: Murmur.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 12/16/09 ROTARIX #1-developed belly pain and vomiting. 1/20/10 ROTARIX #2-on 1/23/10 intussusception.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=378753&WAYBACKHISTORY=ON


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