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This is VAERS ID 444118

History of Changes from the VAERS Wayback Machine

First Appeared on 12/14/2011

VAERS ID: 444118
VAERS Form:
Age:0.2
Gender:Female
Location:Maryland
Vaccinated:2011-10-24
Onset:2011-10-31
Submitted:2011-11-14
Entered:2011-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B305AA / 0 LL / UN
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 1189AA / 0 RL / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F08531 / 0 LL / UN
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB2269 / 0 - / PO

Administered by: Private      Purchased by: Public
Symptoms: Intussusception, Vomiting, Ultrasound abdomen abnormal

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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Concern of increased spit up.
Allergies:
Diagnostic Lab Data: Intussusception.
CDC 'Split Type':

Write-up: Went to ER with severe vomiting. Ultrasound found intussusception.


Changed on 5/13/2013

VAERS ID: 444118 Before After
VAERS Form:
Age:0.2
Gender:Female
Location:Maryland
Vaccinated:2011-10-24
Onset:2011-10-31
Submitted:2011-11-14
Entered:2011-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B305AA / 0 LL / UN
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 1189AA / 0 RL / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F08531 / 0 LL / UN
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB2269 / 0 - / PO
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB2269 / 0 - / PO

Administered by: Private      Purchased by: Public
Symptoms: Intussusception, Vomiting, Ultrasound abdomen abnormal

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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Concern of increased spit up.
Allergies:
Diagnostic Lab Data: Intussusception.
CDC 'Split Type':

Write-up: Went to ER with severe vomiting. Ultrasound found intussusception.


Changed on 2/14/2017

VAERS ID: 444118 Before After
VAERS Form:
Age:0.2 0.17
Gender:Female
Location:Maryland
Vaccinated:2011-10-24
Onset:2011-10-31
Submitted:2011-11-14
Entered:2011-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B305AA / 0 LL / UN
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 1189AA / 0 RL / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F08531 / 0 LL / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB2269 / 0 - / PO

Administered by: Private      Purchased by: Public
Symptoms: Intussusception, Vomiting, Ultrasound abdomen abnormal

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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Concern of increased spit up.
Allergies:
Diagnostic Lab Data: Intussusception.
CDC 'Split Type':

Write-up: Went to ER with severe vomiting. Ultrasound found intussusception.


Changed on 9/14/2017

VAERS ID: 444118 Before After
VAERS Form:(blank) 1
Age:0.17
Gender:Female
Location:Maryland
Vaccinated:2011-10-24
Onset:2011-10-31
Submitted:2011-11-14
Entered:2011-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B305AA / 0 1 LL / UN
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 1189AA / 0 1 RL / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F08531 / 0 1 LL / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB2269 / 0 1 - MO / PO

Administered by: Private      Purchased by: Public
Symptoms: Intussusception, Vomiting, Ultrasound abdomen abnormal

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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Concern of increased spit up.
Allergies:
Diagnostic Lab Data: Intussusception.
CDC 'Split Type':

Write-up: Went to ER with severe vomiting. Ultrasound found intussusception.


Changed on 2/14/2018

VAERS ID: 444118 Before After
VAERS Form:1
Age:0.17
Gender:Female
Location:Maryland
Vaccinated:2011-10-24
Onset:2011-10-31
Submitted:2011-11-14
Entered:2011-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B305AA / 1 LL / UN
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 1189AA / 1 RL / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F08531 / 1 LL / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB2269 / 1 MO / PO

Administered by: Private      Purchased by: Public
Symptoms: Intussusception, Vomiting, Ultrasound abdomen abnormal

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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Concern of increased spit up.
Allergies:
Diagnostic Lab Data: Intussusception.
CDC 'Split Type':

Write-up: Went to ER with severe vomiting. Ultrasound found intussusception.


Changed on 6/14/2018

VAERS ID: 444118 Before After
VAERS Form:1
Age:0.17
Gender:Female
Location:Maryland
Vaccinated:2011-10-24
Onset:2011-10-31
Submitted:2011-11-14
Entered:2011-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B305AA / 1 LL / UN
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 1189AA / 1 RL / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F08531 / 1 LL / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB2269 / 1 MO / PO

Administered by: Private      Purchased by: Public
Symptoms: Intussusception, Vomiting, Ultrasound abdomen abnormal

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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Concern of increased spit up.
Allergies:
Diagnostic Lab Data: Intussusception.
CDC 'Split Type':

Write-up: Went to ER with severe vomiting. Ultrasound found intussusception.

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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=444118&WAYBACKHISTORY=ON


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