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This is VAERS ID 427945

History of Changes from the VAERS Wayback Machine

First Appeared on 8/12/2011

VAERS ID: 427945
VAERS Form:
Age:0.3
Gender:Female
Location:Georgia
Vaccinated:2011-04-29
Onset:2011-05-03
Submitted:2011-07-22
Entered:2011-07-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3542AA / 0 LL / IM
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVB842AA / 0 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 916302 / 0 RL / IM
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41DB154A / 0 - / PO

Administered by: Private      Purchased by: Private
Symptoms: Abdominal mass, Crying, Intussusception, Irritability, Pain, Screaming, Vomiting, X-ray abnormal, Ultrasound abdomen abnormal, Induration, Abdominal X-ray, Stomach mass

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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Slight cold, we had delayed shots for about 2 weeks before due to having a cold
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Started with a painful fit and finally pushed out a bowel movement. After that the fierce vomiting and painful squeals about every 30-45 minutes. Pt could not keep anything down even for seconds after having them. At around 9am I noticed a larger lump in her sunken stomach that felt very hard. Was headed to hospital when pediatrician called and requested to go to his office instead of emergency room. Saw him at 2 and the vomitting had continued until bile. Saw the Pediatrician and he sent us to Childrens health care. There we had an x-ray and then an ultrasound to conclude it was intussusception.


Changed on 5/13/2013

VAERS ID: 427945 Before After
VAERS Form:
Age:0.3
Gender:Female
Location:Georgia
Vaccinated:2011-04-29
Onset:2011-05-03
Submitted:2011-07-22
Entered:2011-07-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3542AA / 0 LL / IM
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVB842AA / 0 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 916302 / 0 RL / IM
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41DB154A / 0 - / PO
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41DB154A / 0 - / PO

Administered by: Private      Purchased by: Private
Symptoms: Abdominal mass, Crying, Intussusception, Irritability, Pain, Screaming, Vomiting, X-ray abnormal, Ultrasound abdomen abnormal, Induration, Abdominal X-ray, Stomach mass

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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Slight cold, we had delayed shots for about 2 weeks before due to having a cold
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Started with a painful fit and finally pushed out a bowel movement. After that the fierce vomiting and painful squeals about every 30-45 minutes. Pt could not keep anything down even for seconds after having them. At around 9am I noticed a larger lump in her sunken stomach that felt very hard. Was headed to hospital when pediatrician called and requested to go to his office instead of emergency room. Saw him at 2 and the vomitting had continued until bile. Saw the Pediatrician and he sent us to Childrens health care. There we had an x-ray and then an ultrasound to conclude it was intussusception.


Changed on 2/14/2017

VAERS ID: 427945 Before After
VAERS Form:
Age:0.3 0.28
Gender:Female
Location:Georgia
Vaccinated:2011-04-29
Onset:2011-05-03
Submitted:2011-07-22
Entered:2011-07-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3542AA / 0 LL / IM
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVB842AA / 0 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 916302 / 0 RL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41DB154A / 0 - / PO

Administered by: Private      Purchased by: Private
Symptoms: Abdominal mass, Crying, Intussusception, Irritability, Pain, Screaming, Vomiting, X-ray abnormal, Ultrasound abdomen abnormal, Induration, Abdominal X-ray, Stomach mass

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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Slight cold, we had delayed shots for about 2 weeks before due to having a cold
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Started with a painful fit and finally pushed out a bowel movement. After that the fierce vomiting and painful squeals about every 30-45 minutes. Pt could not keep anything down even for seconds after having them. At around 9am I noticed a larger lump in her sunken stomach that felt very hard. Was headed to hospital when pediatrician called and requested to go to his office instead of emergency room. Saw him at 2 and the vomitting had continued until bile. Saw the Pediatrician and he sent us to Childrens health care. There we had an x-ray and then an ultrasound to conclude it was intussusception.


Changed on 9/14/2017

VAERS ID: 427945 Before After
VAERS Form:(blank) 1
Age:0.28
Gender:Female
Location:Georgia
Vaccinated:2011-04-29
Onset:2011-05-03
Submitted:2011-07-22
Entered:2011-07-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3542AA / 0 1 LL / IM
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVB842AA / 0 1 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 916302 / 0 1 RL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41DB154A / 0 1 - MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Abdominal mass, Crying, Intussusception, Irritability, Pain, Screaming, Vomiting, X-ray abnormal, Ultrasound abdomen abnormal, Induration, Abdominal X-ray, Stomach mass

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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Slight cold, we had delayed shots for about 2 weeks before due to having a cold
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Started with a painful fit and finally pushed out a bowel movement. After that the fierce vomiting and painful squeals about every 30-45 minutes. Pt could not keep anything down even for seconds after having them. At around 9am I noticed a larger lump in her sunken stomach that felt very hard. Was headed to hospital when pediatrician called and requested to go to his office instead of emergency room. Saw him at 2 and the vomitting had continued until bile. Saw the Pediatrician and he sent us to Childrens health care. There we had an x-ray and then an ultrasound to conclude it was intussusception.


Changed on 2/14/2018

VAERS ID: 427945 Before After
VAERS Form:1
Age:0.28
Gender:Female
Location:Georgia
Vaccinated:2011-04-29
Onset:2011-05-03
Submitted:2011-07-22
Entered:2011-07-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3542AA / 1 LL / IM
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVB842AA / 1 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 916302 / 1 RL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41DB154A / 1 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Abdominal mass, Crying, Intussusception, Irritability, Pain, Screaming, Vomiting, X-ray abnormal, Ultrasound abdomen abnormal, Induration, Abdominal X-ray, Stomach mass

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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Slight cold, we had delayed shots for about 2 weeks before due to having a cold
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Started with a painful fit and finally pushed out a bowel movement. After that the fierce vomiting and painful squeals about every 30-45 minutes. Pt could not keep anything down even for seconds after having them. At around 9am I noticed a larger lump in her sunken stomach that felt very hard. Was headed to hospital when pediatrician called and requested to go to his office instead of emergency room. Saw him at 2 and the vomitting had continued until bile. Saw the Pediatrician and he sent us to Childrens health care. There we had an x-ray and then an ultrasound to conclude it was intussusception.


Changed on 6/14/2018

VAERS ID: 427945 Before After
VAERS Form:1
Age:0.28
Gender:Female
Location:Georgia
Vaccinated:2011-04-29
Onset:2011-05-03
Submitted:2011-07-22
Entered:2011-07-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3542AA / 1 LL / IM
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVB842AA / 1 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 916302 / 1 RL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41DB154A / 1 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Abdominal mass, Crying, Intussusception, Irritability, Pain, Screaming, Vomiting, X-ray abnormal, Ultrasound abdomen abnormal, Induration, Abdominal X-ray, Stomach mass

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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Slight cold, we had delayed shots for about 2 weeks before due to having a cold
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Started with a painful fit and finally pushed out a bowel movement. After that the fierce vomiting and painful squeals about every 30-45 minutes. Pt could not keep anything down even for seconds after having them. At around 9am I noticed a larger lump in her sunken stomach that felt very hard. Was headed to hospital when pediatrician called and requested to go to his office instead of emergency room. Saw him at 2 and the vomitting had continued until bile. Saw the Pediatrician and he sent us to Childrens health care. There we had an x-ray and then an ultrasound to conclude it was intussusception.

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