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This is VAERS ID 435124

History of Changes from the VAERS Wayback Machine

First Appeared on 10/11/2011

VAERS ID: 435124
VAERS Form:
Age:
Gender:Female
Location:Minnesota
Vaccinated:2011-03-04
Onset:2011-08-11
Submitted:2011-09-20
Entered:2011-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB096A / 1 - / PO

Administered by: Private      Purchased by: Private
Symptoms: Intussusception, Vomiting, Exposure to communicable disease, Enema administration

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: In mssusc-phun of intestine~Rotavirus (no brand name)~2~1.00~Patient
Other Medications: None
Current Illness: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data: Intestinal intussusception - reduced - air enema
CDC 'Split Type':

Write-up: Sudden onset bilious vomiting. Intestinal intussusception. Hospitalized - reduced with air enema. Recovered well. Hospitalization complicated by measles exposure.


Changed on 5/13/2013

VAERS ID: 435124 Before After
VAERS Form:
Age:
Gender:Female
Location:Minnesota
Vaccinated:2011-03-04
Onset:2011-08-11
Submitted:2011-09-20
Entered:2011-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB096A / 1 - / PO
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB096A / 1 - / PO

Administered by: Private      Purchased by: Private
Symptoms: Intussusception, Vomiting, Exposure to communicable disease, Enema administration

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: In mssusc-phun of intestine~Rotavirus (no brand name)~2~1.00~Patient
Other Medications: None
Current Illness: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data: Intestinal intussusception - reduced - air enema
CDC 'Split Type':

Write-up: Sudden onset bilious vomiting. Intestinal intussusception. Hospitalized - reduced with air enema. Recovered well. Hospitalization complicated by measles exposure.


Changed on 6/14/2014

VAERS ID: 435124 Before After
VAERS Form:
Age:
Gender:Female
Location:Minnesota
Vaccinated:2011-03-04
Onset:2011-08-11
Submitted:2011-09-20
Entered:2011-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB096A / 1 - / PO

Administered by: Private      Purchased by: Private
Symptoms: Intussusception, Vomiting, Exposure to communicable disease, Enema administration

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: In mssusc-phun of intestine~Rotavirus (no brand name)~2~1.00~Patient
Other Medications: None
Current Illness: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data: Intestinal intussusception - reduced - air enema
CDC 'Split Type':

Write-up: Sudden onset bilious vomiting. Intestinal intussusception. Hospitalized - reduced with air enema. Recovered well. Hospitalization complicated by measles exposure.


Changed on 2/14/2017

VAERS ID: 435124 Before After
VAERS Form:
Age:
Gender:Female
Location:Minnesota
Vaccinated:2011-03-04
Onset:2011-08-11
Submitted:2011-09-20
Entered:2011-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB096A / 1 - / PO

Administered by: Private      Purchased by: Private
Symptoms: Intussusception, Vomiting, Exposure to communicable disease, Enema administration

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: In mssusc-phun of intestine~Rotavirus (no brand name)~2~1.00~Patient
Other Medications:
Current Illness: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data: Intestinal intussusception - reduced - air enema
CDC 'Split Type':

Write-up: Sudden onset bilious vomiting. Intestinal intussusception. Hospitalized - reduced with air enema. Recovered well. Hospitalization complicated by measles exposure.


Changed on 4/14/2017

VAERS ID: 435124 Before After
VAERS Form:
Age:
Gender:Female
Location:Minnesota
Vaccinated:2011-03-04
Onset:2011-08-11
Submitted:2011-09-20
Entered:2011-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB096A / 1 - / PO

Administered by: Private      Purchased by: Private
Symptoms: Intussusception, Vomiting, Exposure to communicable disease, Enema administration

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: In mssusc-phun of intestine~Rotavirus (no brand name)~2~1.00~Patient
Other Medications: None
Current Illness: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data: Intestinal intussusception - reduced - air enema
CDC 'Split Type':

Write-up: Sudden onset bilious vomiting. Intestinal intussusception. Hospitalized - reduced with air enema. Recovered well. Hospitalization complicated by measles exposure.


Changed on 9/14/2017

VAERS ID: 435124 Before After
VAERS Form:(blank) 1
Age:
Gender:Female
Location:Minnesota
Vaccinated:2011-03-04
Onset:2011-08-11
Submitted:2011-09-20
Entered:2011-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB096A / 1 2 - MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Intussusception, Vomiting, Exposure to communicable disease, Enema administration

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: In mssusc-phun of intestine~Rotavirus (no brand name)~2~1.00~Patient
Other Medications: None
Current Illness: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data: Intestinal intussusception - reduced - air enema
CDC 'Split Type':

Write-up: Sudden onset bilious vomiting. Intestinal intussusception. Hospitalized - reduced with air enema. Recovered well. Hospitalization complicated by measles exposure.


Changed on 2/14/2018

VAERS ID: 435124 Before After
VAERS Form:1
Age:
Gender:Female
Location:Minnesota
Vaccinated:2011-03-04
Onset:2011-08-11
Submitted:2011-09-20
Entered:2011-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB096A / 2 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Intussusception, Vomiting, Exposure to communicable disease, Enema administration

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: In mssusc-phun of intestine~Rotavirus (no brand name)~2~1.00~Patient
Other Medications: None
Current Illness: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data: Intestinal intussusception - reduced - air enema
CDC 'Split Type':

Write-up: Sudden onset bilious vomiting. Intestinal intussusception. Hospitalized - reduced with air enema. Recovered well. Hospitalization complicated by measles exposure.


Changed on 6/14/2018

VAERS ID: 435124 Before After
VAERS Form:1
Age:
Gender:Female
Location:Minnesota
Vaccinated:2011-03-04
Onset:2011-08-11
Submitted:2011-09-20
Entered:2011-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB096A / 2 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Intussusception, Vomiting, Exposure to communicable disease, Enema administration

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: In mssusc-phun of intestine~Rotavirus (no brand name)~2~1.00~Patient
Other Medications: None
Current Illness: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data: Intestinal intussusception - reduced - air enema
CDC 'Split Type':

Write-up: Sudden onset bilious vomiting. Intestinal intussusception. Hospitalized - reduced with air enema. Recovered well. Hospitalization complicated by measles exposure.

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