National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 449701

History of Changes from the VAERS Wayback Machine

First Appeared on 3/12/2012

VAERS ID: 449701
VAERS Form:
Age:0.4
Gender:Female
Location:Nevada
Vaccinated:2012-02-10
Onset:2012-02-11
Submitted:2012-02-15
Entered:2012-02-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C4155AA / 0 LL / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F30922 / 1 LL / UN
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB200A / 1 - / PO

Administered by: Private      Purchased by: Other
Symptoms: Barium enema, Intussusception

Life Threatening? No
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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Barium enema done to treat intussusception
CDC 'Split Type':

Write-up: Intussusception - s/p ROTARIX vaccine reduced in hospital.


Changed on 5/13/2013

VAERS ID: 449701 Before After
VAERS Form:
Age:0.4
Gender:Female
Location:Nevada
Vaccinated:2012-02-10
Onset:2012-02-11
Submitted:2012-02-15
Entered:2012-02-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C4155AA / 0 LL / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F30922 / 1 LL / UN
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB200A / 1 - / PO
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB200A / 1 - / PO

Administered by: Private      Purchased by: Other
Symptoms: Barium enema, Intussusception

Life Threatening? No
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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Barium enema done to treat intussusception
CDC 'Split Type':

Write-up: Intussusception - s/p ROTARIX vaccine reduced in hospital.


Changed on 6/14/2014

VAERS ID: 449701 Before After
VAERS Form:
Age:0.4
Gender:Female
Location:Nevada
Vaccinated:2012-02-10
Onset:2012-02-11
Submitted:2012-02-15
Entered:2012-02-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C4155AA / 0 LL / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F30922 / 1 LL / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB200A / 1 - / PO

Administered by: Private      Purchased by: Other
Symptoms: Barium enema, Intussusception

Life Threatening? No
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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Barium enema done to treat intussusception
CDC 'Split Type':

Write-up: Intussusception - s/p ROTARIX vaccine reduced in hospital.


Changed on 3/14/2015

VAERS ID: 449701 Before After
VAERS Form:
Age:0.4
Gender:Female
Location:Nevada
Vaccinated:2012-02-10
Onset:2012-02-11
Submitted:2012-02-15
Entered:2012-02-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C4155AA / 0 LL / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F30922 / 1 LL / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB200A / 1 - / PO

Administered by: Private      Purchased by: Other
Symptoms: Barium enema, Intussusception

Life Threatening? No
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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Barium enema done to treat intussusception
CDC 'Split Type':

Write-up: Intussusception - s/p ROTARIX vaccine reduced in hospital.


Changed on 2/14/2017

VAERS ID: 449701 Before After
VAERS Form:
Age:0.4 0.35
Gender:Female
Location:Nevada
Vaccinated:2012-02-10
Onset:2012-02-11
Submitted:2012-02-15
Entered:2012-02-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C4155AA / 0 LL / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F30922 / 1 LL / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB200A / 1 - / PO

Administered by: Private      Purchased by: Other
Symptoms: Barium enema, Intussusception

Life Threatening? No
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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Barium enema done to treat intussusception
CDC 'Split Type':

Write-up: Intussusception - s/p ROTARIX vaccine reduced in hospital.


Changed on 9/14/2017

VAERS ID: 449701 Before After
VAERS Form:(blank) 1
Age:0.35
Gender:Female
Location:Nevada
Vaccinated:2012-02-10
Onset:2012-02-11
Submitted:2012-02-15
Entered:2012-02-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C4155AA / 0 1 LL / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F30922 / 1 2 LL / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB200A / 1 2 - MO / PO

Administered by: Private      Purchased by: Other
Symptoms: Barium enema, Intussusception

Life Threatening? No
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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Barium enema done to treat intussusception
CDC 'Split Type':

Write-up: Intussusception - s/p ROTARIX vaccine reduced in hospital.


Changed on 2/14/2018

VAERS ID: 449701 Before After
VAERS Form:1
Age:0.35
Gender:Female
Location:Nevada
Vaccinated:2012-02-10
Onset:2012-02-11
Submitted:2012-02-15
Entered:2012-02-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C4155AA / 1 LL / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F30922 / 2 LL / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB200A / 2 MO / PO

Administered by: Private      Purchased by: Other
Symptoms: Barium enema, Intussusception

Life Threatening? No
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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Barium enema done to treat intussusception
CDC 'Split Type':

Write-up: Intussusception - s/p ROTARIX vaccine reduced in hospital.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=449701&WAYBACKHISTORY=ON


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