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This is VAERS ID 460202

History of Changes from the VAERS Wayback Machine

First Appeared on 8/13/2012

VAERS ID: 460202
VAERS Form:
Age:0.4
Gender:Female
Location:Rhode Island
Vaccinated:2012-07-13
Onset:2012-07-13
Submitted:2012-07-18
Entered:2012-07-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B326AA / 1 RL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 1310AA / 1 LL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F53376 / 1 LL / IM
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB207A / 1 - / PO

Administered by: Private      Purchased by: Public
Symptoms: Barium enema abnormal, Intussusception, Enema administration

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: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Barium enema with reduction
CDC 'Split Type':

Write-up: Intussusception.


Changed on 5/13/2013

VAERS ID: 460202 Before After
VAERS Form:
Age:0.4
Gender:Female
Location:Rhode Island
Vaccinated:2012-07-13
Onset:2012-07-13
Submitted:2012-07-18
Entered:2012-07-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B326AA / 1 RL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 1310AA / 1 LL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F53376 / 1 LL / IM
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB207A / 1 - / PO
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB207A / 1 - / PO

Administered by: Private      Purchased by: Public
Symptoms: Barium enema abnormal, Intussusception, Enema administration

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: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Barium enema with reduction
CDC 'Split Type':

Write-up: Intussusception.


Changed on 2/14/2017

VAERS ID: 460202 Before After
VAERS Form:
Age:0.4 0.35
Gender:Female
Location:Rhode Island
Vaccinated:2012-07-13
Onset:2012-07-13
Submitted:2012-07-18
Entered:2012-07-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B326AA / 1 RL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 1310AA / 1 LL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F53376 / 1 LL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB207A / 1 - / PO

Administered by: Private      Purchased by: Public
Symptoms: Barium enema abnormal, Intussusception, Enema administration

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: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Barium enema with reduction
CDC 'Split Type':

Write-up: Intussusception.


Changed on 9/14/2017

VAERS ID: 460202 Before After
VAERS Form:(blank) 1
Age:0.35
Gender:Female
Location:Rhode Island
Vaccinated:2012-07-13
Onset:2012-07-13
Submitted:2012-07-18
Entered:2012-07-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B326AA / 1 2 RL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 1310AA / 1 2 LL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F53376 / 1 2 LL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB207A / 1 2 - MO / PO

Administered by: Private      Purchased by: Public
Symptoms: Barium enema abnormal, Intussusception, Enema administration

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: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Barium enema with reduction
CDC 'Split Type':

Write-up: Intussusception.


Changed on 2/14/2018

VAERS ID: 460202 Before After
VAERS Form:1
Age:0.35
Gender:Female
Location:Rhode Island
Vaccinated:2012-07-13
Onset:2012-07-13
Submitted:2012-07-18
Entered:2012-07-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B326AA / 2 RL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 1310AA / 2 LL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F53376 / 2 LL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB207A / 2 MO / PO

Administered by: Private      Purchased by: Public
Symptoms: Barium enema abnormal, Intussusception, Enema administration

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: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Barium enema with reduction
CDC 'Split Type':

Write-up: Intussusception.

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