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History of Changes from the VAERS Wayback Machine |
First Appeared on 8/31/2010 |
VAERS ID: | 396263 |
VAERS Form: | |
Age: | 0.2 |
Gender: | Female |
Location: | South Carolina |
Vaccinated: | 2010-08-09 |
Onset: | 2010-08-14 |
Submitted: | 2010-08-18 |
Entered: | 2010-08-23 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR | C3682A / 0 | LL / IM |
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. | 1484Y / 1 | RL / IM |
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH | E61989 / 0 | RL / IM |
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS | A41FB05 / 0 | - / PO |
Administered by: Private Purchased by: Private
Symptoms: Barium double contrast, Intussusception, Vomiting, Enema administration, Rectal tenesmus, Radioisotope 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: 1
Write-up: Intussusception =$g vomiting 8 days after vaccines; air contrast barium enema diagnosed and reduced intussusception.
Vaccinated: | 2010-08-09 |
Onset: | 2010-08-14 |
Submitted: | 2010-08-18 |
Entered: | 2010-08-23 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR | C3682A / 0 | LL / IM |
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. | 1484Y / 1 | RL / IM |
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH | E61989 / 0 | RL / IM |
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS | A41FB05 / 0 | - / PO |
Administered by: Private Purchased by: Private
Symptoms: Barium double contrast, Intussusception, Vomiting, Enema administration, Rectal tenesmus, Radioisotope scan normal
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1
Write-up: Intussusception =$g vomiting 8 days after vaccines; air contrast barium enema diagnosed and reduced intussusception.
Vaccinated: | 2010-08-09 |
Onset: | 2010-08-14 |
Submitted: | 2010-08-18 |
Entered: | 2010-08-23 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR | C3682A / 0 | LL / IM |
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. | 1484Y / 1 | RL / IM |
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH | E61989 / 0 | RL / IM |
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS | A41FB05 / 0 | - / PO |
Administered by: Private Purchased by: Private
Symptoms: Abdominal pain, Barium double contrast, Constipation, Dehydration, Intussusception, Irritability, Mucous stools, Sleep disorder, Vomiting, Enema administration, Ultrasound abdomen abnormal, Rectal tenesmus, Urine output decreased, Blood electrolytes normal, Radioisotope 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: 1
Write-up: Intussusception =$g vomiting 8 days after vaccines; air contrast barium enema diagnosed and reduced intussusception.
Vaccinated: | 2010-08-09 |
Onset: | 2010-08-14 |
Submitted: | 2010-08-18 |
Entered: | 2010-08-23 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR | C3682A / 0 | LL / IM |
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. | 1484Y / 1 | RL / IM |
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH | E61989 / 0 | RL / IM |
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS | A41FB05 / 0 | - / PO |
Administered by: Private Purchased by: Private
Symptoms: Abdominal pain, Barium double contrast, Constipation, Dehydration, Intussusception, Irritability, Mucous stools, Sleep disorder, Vomiting, Enema administration, Ultrasound abdomen abnormal, Rectal tenesmus, Urine output decreased, Blood electrolytes normal, Radioisotope scan normal
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1
Write-up: Intussusception =$g vomiting 8 days after vaccines; air contrast barium enema diagnosed and reduced intussusception.
Vaccinated: | 2010-08-09 |
Onset: | 2010-08-14 |
Submitted: | 2010-08-18 |
Entered: | 2010-08-23 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR | C3682A / 0 | LL / IM |
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. | 1484Y / 1 | RL / IM |
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH | E61989 / 0 | RL / IM |
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS | A41FB05 / 0 | - / PO |
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS | A41FB05 / 0 | - / PO |
Administered by: Private Purchased by: Private
Symptoms: Barium double contrast, Intussusception, Vomiting, Enema administration
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: 1
Write-up: Intussusception =$g vomiting 8 days after vaccines; air contrast barium enema diagnosed and reduced intussusception.
Vaccinated: | 2010-08-09 |
Onset: | 2010-08-14 |
Submitted: | 2010-08-18 |
Entered: | 2010-08-23 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR | C3682A / 0 | LL / IM |
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. | 1484Y / 1 | RL / IM |
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH | E61989 / 0 | RL / IM |
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS | A41FB05 / 0 | - / PO |
Administered by: Private Purchased by: Private
Symptoms: Barium double contrast, Intussusception, Vomiting, Enema administration
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1
Write-up: Intussusception =$g vomiting 8 days after vaccines; air contrast barium enema diagnosed and reduced intussusception.
Vaccinated: | 2010-08-09 |
Onset: | 2010-08-14 |
Submitted: | 2010-08-18 |
Entered: | 2010-08-23 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR | C3682A / 0 1 | LL / IM |
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. | 1484Y / 1 2 | RL / IM |
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH | E61989 / 0 1 | RL / IM |
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS | A41FB05 / 0 1 | - MO / PO |
Administered by: Private Purchased by: Private
Symptoms: Barium double contrast, Intussusception, Vomiting, Enema administration
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: 1
Write-up: Intussusception =$g vomiting 8 days after vaccines; air contrast barium enema diagnosed and reduced intussusception.
Vaccinated: | 2010-08-09 |
Onset: | 2010-08-14 |
Submitted: | 2010-08-18 |
Entered: | 2010-08-23 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR | C3682A / 1 | LL / IM |
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. | 1484Y / 2 | RL / IM |
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH | E61989 / 1 | RL / IM |
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS | A41FB05 / 1 | MO / PO |
Administered by: Private Purchased by: Private
Symptoms: Barium double contrast, Intussusception, Vomiting, Enema administration
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1
Write-up: Intussusception =$g vomiting 8 days after vaccines; air contrast barium enema diagnosed and reduced intussusception.
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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=396263&WAYBACKHISTORY=ON
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