National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 435498

History of Changes from the VAERS Wayback Machine

First Appeared on 10/11/2011

VAERS ID: 435498
VAERS Form:
Age:0.2
Gender:Female
Location:New York
Vaccinated:2011-07-06
Onset:2011-08-18
Submitted:2011-09-24
Entered:2011-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 0 UN / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 1515J / 0 UN / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH E63641 / 0 UN / IM
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS 102A / 0 - / PO

Administered by: Private      Purchased by: Private
Symptoms: Intussusception, Surgery, Vomiting, Vitello-intestinal duct remnant

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: 10     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: no
Allergies:
Diagnostic Lab Data: Patient had Meckels diverticulum. Intussusception in small bowel.
CDC 'Split Type':

Write-up: Vomiting after every feeding for 2 days. Vomiting even without any liquids or feedings. Baby was hospitalize with an IV and the intussusception was found once she started vomiting bios and they did an internal exam. She had emergency surgery 30 hours after first symptoms.


Changed on 11/14/2011

VAERS ID: 435498 Before After
VAERS Form:
Age:0.2
Gender:Female
Location:New York
Vaccinated:2011-07-06
Onset:2011-08-18
Submitted:2011-09-24
Entered:2011-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (NO BRAND NAME) DTAP + HEPB + IPV (PEDIARIX) / UNKNOWN MANUFACTURER GLAXOSMITHKLINE BIOLOGICALS - AC21B280BA / 0 UN / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 1515J 1515Y / 0 UN / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH E63641 / 0 UN / IM
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS 102A A41CB2102A / 0 - / PO

Administered by: Private      Purchased by: Private
Symptoms: Intussusception, Surgery, Vomiting, Vitello-intestinal duct remnant

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: 10     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: no
Allergies:
Diagnostic Lab Data: Patient had Meckels diverticulum. Intussusception in small bowel.
CDC 'Split Type':

Write-up: Vomiting after every feeding for 2 days. Vomiting even without any liquids or feedings. Baby was hospitalize with an IV and the intussusception was found once she started vomiting bios and they did an internal exam. She had emergency surgery 30 hours after first symptoms.


Changed on 5/13/2013

VAERS ID: 435498 Before After
VAERS Form:
Age:0.2
Gender:Female
Location:New York
Vaccinated:2011-07-06
Onset:2011-08-18
Submitted:2011-09-24
Entered:2011-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B280BA / 0 UN / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 1515Y / 0 UN / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH E63641 / 0 UN / IM
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41CB2102A / 0 - / PO
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41CB2102A / 0 - / PO

Administered by: Private      Purchased by: Private
Symptoms: Intussusception, Surgery, Vomiting, Vitello-intestinal duct remnant

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: 10     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: no
Allergies:
Diagnostic Lab Data: Patient had Meckels diverticulum. Intussusception in small bowel.
CDC 'Split Type':

Write-up: Vomiting after every feeding for 2 days. Vomiting even without any liquids or feedings. Baby was hospitalize with an IV and the intussusception was found once she started vomiting bios and they did an internal exam. She had emergency surgery 30 hours after first symptoms.


Changed on 2/14/2017

VAERS ID: 435498 Before After
VAERS Form:
Age:0.2 0.15
Gender:Female
Location:New York
Vaccinated:2011-07-06
Onset:2011-08-18
Submitted:2011-09-24
Entered:2011-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B280BA / 0 UN / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 1515Y / 0 UN / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH E63641 / 0 UN / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41CB2102A / 0 - / PO

Administered by: Private      Purchased by: Private
Symptoms: Intussusception, Surgery, Vomiting, Vitello-intestinal duct remnant

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: 10     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: no
Allergies:
Diagnostic Lab Data: Patient had Meckels diverticulum. Intussusception in small bowel.
CDC 'Split Type':

Write-up: Vomiting after every feeding for 2 days. Vomiting even without any liquids or feedings. Baby was hospitalize with an IV and the intussusception was found once she started vomiting bios and they did an internal exam. She had emergency surgery 30 hours after first symptoms.


Changed on 9/14/2017

VAERS ID: 435498 Before After
VAERS Form:(blank) 1
Age:0.15
Gender:Female
Location:New York
Vaccinated:2011-07-06
Onset:2011-08-18
Submitted:2011-09-24
Entered:2011-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B280BA / 0 1 UN / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 1515Y / 0 1 UN / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH E63641 / 0 1 UN / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41CB2102A / 0 1 - MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Intussusception, Surgery, Vomiting, Vitello-intestinal duct remnant

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: 10     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: no
Allergies:
Diagnostic Lab Data: Patient had Meckels diverticulum. Intussusception in small bowel.
CDC 'Split Type':

Write-up: Vomiting after every feeding for 2 days. Vomiting even without any liquids or feedings. Baby was hospitalize with an IV and the intussusception was found once she started vomiting bios and they did an internal exam. She had emergency surgery 30 hours after first symptoms.


Changed on 2/14/2018

VAERS ID: 435498 Before After
VAERS Form:1
Age:0.15
Gender:Female
Location:New York
Vaccinated:2011-07-06
Onset:2011-08-18
Submitted:2011-09-24
Entered:2011-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B280BA / 1 UN / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 1515Y / 1 UN / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH E63641 / 1 UN / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41CB2102A / 1 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Intussusception, Surgery, Vomiting, Vitello-intestinal duct remnant

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: 10     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: no
Allergies:
Diagnostic Lab Data: Patient had Meckels diverticulum. Intussusception in small bowel.
CDC 'Split Type':

Write-up: Vomiting after every feeding for 2 days. Vomiting even without any liquids or feedings. Baby was hospitalize with an IV and the intussusception was found once she started vomiting bios and they did an internal exam. She had emergency surgery 30 hours after first symptoms.


Changed on 6/14/2018

VAERS ID: 435498 Before After
VAERS Form:1
Age:0.15
Gender:Female
Location:New York
Vaccinated:2011-07-06
Onset:2011-08-18
Submitted:2011-09-24
Entered:2011-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B280BA / 1 UN / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 1515Y / 1 UN / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH E63641 / 1 UN / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41CB2102A / 1 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Intussusception, Surgery, Vomiting, Vitello-intestinal duct remnant

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: 10     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: no
Allergies:
Diagnostic Lab Data: Patient had Meckels diverticulum. Intussusception in small bowel.
CDC 'Split Type':

Write-up: Vomiting after every feeding for 2 days. Vomiting even without any liquids or feedings. Baby was hospitalize with an IV and the intussusception was found once she started vomiting bios and they did an internal exam. She had emergency surgery 30 hours after first symptoms.


Changed on 8/14/2018

VAERS ID: 435498 Before After
VAERS Form:1
Age:0.15
Gender:Female
Location:New York
Vaccinated:2011-07-06
Onset:2011-08-18
Submitted:2011-09-24
Entered:2011-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B280BA / 1 UN / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 1515Y / 1 UN / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH E63641 / 1 UN / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41CB2102A / 1 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Intussusception, Surgery, Vomiting, Vitello-intestinal duct remnant

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: 10     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: no
Allergies:
Diagnostic Lab Data: Patient had Meckels diverticulum. Intussusception in small bowel.
CDC 'Split Type':

Write-up: Vomiting after every feeding for 2 days. Vomiting even without any liquids or feedings. Baby was hospitalize with an IV and the intussusception was found once she started vomiting bios and they did an internal exam. She had emergency surgery 30 hours after first symptoms.


Changed on 9/14/2018

VAERS ID: 435498 Before After
VAERS Form:1
Age:0.15
Gender:Female
Location:New York
Vaccinated:2011-07-06
Onset:2011-08-18
Submitted:2011-09-24
Entered:2011-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B280BA / 1 UN / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 1515Y / 1 UN / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH E63641 / 1 UN / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41CB2102A / 1 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Intussusception, Surgery, Vomiting, Vitello-intestinal duct remnant

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: 10     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: no
Allergies:
Diagnostic Lab Data: Patient had Meckels diverticulum. Intussusception in small bowel.
CDC 'Split Type':

Write-up: Vomiting after every feeding for 2 days. Vomiting even without any liquids or feedings. Baby was hospitalize with an IV and the intussusception was found once she started vomiting bios and they did an internal exam. She had emergency surgery 30 hours after first symptoms.

New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=435498&WAYBACKHISTORY=ON


Copyright © 2018 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166