National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 437718

History of Changes from the VAERS Wayback Machine

First Appeared on 10/11/2011

VAERS ID: 437718
VAERS Form:
Age:0.2
Gender:Male
Location:New York
Vaccinated:2011-09-29
Onset:2011-10-09
Submitted:2011-10-11
Entered:2011-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C39138A / 0 LL / UN
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. AHBVC032AA / 1 LL / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 915383 / 0 RL / UN
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41CB159A / 0 - / PO

Administered by: Private      Purchased by: Private
Symptoms: Intussusception, Surgery

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Intussusception w/ surgical correction.


Changed on 5/13/2013

VAERS ID: 437718 Before After
VAERS Form:
Age:0.2
Gender:Male
Location:New York
Vaccinated:2011-09-29
Onset:2011-10-09
Submitted:2011-10-11
Entered:2011-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C39138A / 0 LL / UN
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. AHBVC032AA / 1 LL / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 915383 / 0 RL / UN
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41CB159A / 0 - / PO
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41CB159A / 0 - / PO

Administered by: Private      Purchased by: Private
Symptoms: Intussusception, Surgery

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Intussusception w/ surgical correction.


Changed on 6/14/2014

VAERS ID: 437718 Before After
VAERS Form:
Age:0.2
Gender:Male
Location:New York
Vaccinated:2011-09-29
Onset:2011-10-09
Submitted:2011-10-11
Entered:2011-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C39138A / 0 LL / UN
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. AHBVC032AA / 1 LL / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 915383 / 0 RL / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41CB159A / 0 - / PO

Administered by: Private      Purchased by: Private
Symptoms: Intussusception, Surgery

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Intussusception w/ surgical correction.


Changed on 2/14/2017

VAERS ID: 437718 Before After
VAERS Form:
Age:0.2 0.18
Gender:Male
Location:New York
Vaccinated:2011-09-29
Onset:2011-10-09
Submitted:2011-10-11
Entered:2011-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C39138A / 0 LL / UN
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. AHBVC032AA / 1 LL / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 915383 / 0 RL / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41CB159A / 0 - / PO

Administered by: Private      Purchased by: Private
Symptoms: Intussusception, Surgery

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Intussusception w/ surgical correction.


Changed on 4/14/2017

VAERS ID: 437718 Before After
VAERS Form:
Age:0.18
Gender:Male
Location:New York
Vaccinated:2011-09-29
Onset:2011-10-09
Submitted:2011-10-11
Entered:2011-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C39138A / 0 LL / UN
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. AHBVC032AA / 1 LL / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 915383 / 0 RL / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41CB159A / 0 - / PO

Administered by: Private      Purchased by: Private
Symptoms: Intussusception, Surgery

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Intussusception w/ surgical correction.


Changed on 9/14/2017

VAERS ID: 437718 Before After
VAERS Form:(blank) 1
Age:0.18
Gender:Male
Location:New York
Vaccinated:2011-09-29
Onset:2011-10-09
Submitted:2011-10-11
Entered:2011-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C39138A / 0 1 LL / UN
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. AHBVC032AA / 1 2 LL / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 915383 / 0 1 RL / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41CB159A / 0 1 - MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Intussusception, Surgery

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Intussusception w/ surgical correction.


Changed on 2/14/2018

VAERS ID: 437718 Before After
VAERS Form:1
Age:0.18
Gender:Male
Location:New York
Vaccinated:2011-09-29
Onset:2011-10-09
Submitted:2011-10-11
Entered:2011-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C39138A / 1 LL / UN
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. AHBVC032AA / 2 LL / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 915383 / 1 RL / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41CB159A / 1 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Intussusception, Surgery

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Intussusception w/ surgical correction.


Changed on 6/14/2018

VAERS ID: 437718 Before After
VAERS Form:1
Age:0.18
Gender:Male
Location:New York
Vaccinated:2011-09-29
Onset:2011-10-09
Submitted:2011-10-11
Entered:2011-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C39138A / 1 LL / UN
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. AHBVC032AA / 2 LL / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 915383 / 1 RL / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41CB159A / 1 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Intussusception, Surgery

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Intussusception w/ surgical correction.


Changed on 8/14/2018

VAERS ID: 437718 Before After
VAERS Form:1
Age:0.18
Gender:Male
Location:New York
Vaccinated:2011-09-29
Onset:2011-10-09
Submitted:2011-10-11
Entered:2011-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C39138A / 1 LL / UN
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. AHBVC032AA / 2 LL / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 915383 / 1 RL / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41CB159A / 1 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Intussusception, Surgery

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Intussusception w/ surgical correction.


Changed on 9/14/2018

VAERS ID: 437718 Before After
VAERS Form:1
Age:0.18
Gender:Male
Location:New York
Vaccinated:2011-09-29
Onset:2011-10-09
Submitted:2011-10-11
Entered:2011-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C39138A / 1 LL / UN
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. AHBVC032AA / 2 LL / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 915383 / 1 RL / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41CB159A / 1 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Intussusception, Surgery

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Intussusception w/ surgical correction.

New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=437718&WAYBACKHISTORY=ON


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