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This is VAERS ID 461714

History of Changes from the VAERS Wayback Machine

First Appeared on 8/13/2012

VAERS ID: 461714
VAERS Form:
Age:0.3
Gender:Female
Location:New York
Vaccinated:2012-07-25
Onset:2012-07-29
Submitted:2012-08-09
Entered:2012-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C4257AA / 1 LL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F56178 / 1 RL / IM
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB207A / 1 - / PO

Administered by: Private      Purchased by: Public
Symptoms: Haematochezia, Haematocrit decreased, Haemoglobin normal, Intussusception, Large intestinal obstruction reduction, Platelet count normal, Vomiting, White blood cell count normal, Enema administration, Ultrasound abdomen, Abdominal X-ray

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal x-ray; Abdominal Ultrasound; CBC: WBC 8.2; Hemoglobin 10.5; Hematocrit 31; Platelet count 436
CDC 'Split Type':

Write-up: 4 days after receiving immunization developed multiple episodes of vomiting becoming bilious went to ER and was discovered to have currant jelly stools. Tx: Air enema reduction of intussusception involving the sigmoid colon.


Changed on 9/12/2012

VAERS ID: 461714 Before After
VAERS Form:
Age:0.3
Gender:Female
Location:New York
Vaccinated:2012-07-25
Onset:2012-07-29
Submitted:2012-08-09
Entered:2012-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C4257AA / 1 LL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F56178 / 1 RL / IM
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB207A / 1 - / PO

Administered by: Private      Purchased by: Public
Symptoms: Haematochezia, Haematocrit decreased, Haemoglobin normal, Intussusception, Large intestinal obstruction reduction, Platelet count normal, Vomiting, White blood cell count normal, Enema administration, Ultrasound abdomen, Abdominal X-ray

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: (blank) 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal x-ray; Abdominal Ultrasound; CBC: WBC 8.2; Hemoglobin 10.5; Hematocrit 31; Platelet count 436
CDC 'Split Type':

Write-up: 4 days after receiving immunization developed multiple episodes of vomiting becoming bilious went to ER and was discovered to have currant jelly stools. Tx: Air enema reduction of intussusception involving the sigmoid colon.


Changed on 5/13/2013

VAERS ID: 461714 Before After
VAERS Form:
Age:0.3
Gender:Female
Location:New York
Vaccinated:2012-07-25
Onset:2012-07-29
Submitted:2012-08-09
Entered:2012-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C4257AA / 1 LL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F56178 / 1 RL / IM
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB207A / 1 - / PO
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB207A / 1 - / PO

Administered by: Private      Purchased by: Public
Symptoms: Haematochezia, Haematocrit decreased, Haemoglobin normal, Intussusception, Large intestinal obstruction reduction, Platelet count normal, Vomiting, White blood cell count normal, Enema administration, Ultrasound abdomen, Abdominal X-ray

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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal x-ray; Abdominal Ultrasound; CBC: WBC 8.2; Hemoglobin 10.5; Hematocrit 31; Platelet count 436
CDC 'Split Type':

Write-up: 4 days after receiving immunization developed multiple episodes of vomiting becoming bilious went to ER and was discovered to have currant jelly stools. Tx: Air enema reduction of intussusception involving the sigmoid colon.


Changed on 2/14/2017

VAERS ID: 461714 Before After
VAERS Form:
Age:0.3 0.34
Gender:Female
Location:New York
Vaccinated:2012-07-25
Onset:2012-07-29
Submitted:2012-08-09
Entered:2012-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C4257AA / 1 LL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F56178 / 1 RL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB207A / 1 - / PO

Administered by: Private      Purchased by: Public
Symptoms: Haematochezia, Haematocrit decreased, Haemoglobin normal, Intussusception, Large intestinal obstruction reduction, Platelet count normal, Vomiting, White blood cell count normal, Enema administration, Ultrasound abdomen, Abdominal X-ray

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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal x-ray; Abdominal Ultrasound; CBC: WBC 8.2; Hemoglobin 10.5; Hematocrit 31; Platelet count 436
CDC 'Split Type':

Write-up: 4 days after receiving immunization developed multiple episodes of vomiting becoming bilious went to ER and was discovered to have currant jelly stools. Tx: Air enema reduction of intussusception involving the sigmoid colon.


Changed on 9/14/2017

VAERS ID: 461714 Before After
VAERS Form:(blank) 1
Age:0.34
Gender:Female
Location:New York
Vaccinated:2012-07-25
Onset:2012-07-29
Submitted:2012-08-09
Entered:2012-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C4257AA / 1 2 LL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F56178 / 1 2 RL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB207A / 1 2 - MO / PO

Administered by: Private      Purchased by: Public
Symptoms: Haematochezia, Haematocrit decreased, Haemoglobin normal, Intussusception, Large intestinal obstruction reduction, Platelet count normal, Vomiting, White blood cell count normal, Enema administration, Ultrasound abdomen, Abdominal X-ray

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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal x-ray; Abdominal Ultrasound; CBC: WBC 8.2; Hemoglobin 10.5; Hematocrit 31; Platelet count 436
CDC 'Split Type':

Write-up: 4 days after receiving immunization developed multiple episodes of vomiting becoming bilious went to ER and was discovered to have currant jelly stools. Tx: Air enema reduction of intussusception involving the sigmoid colon.


Changed on 2/14/2018

VAERS ID: 461714 Before After
VAERS Form:1
Age:0.34
Gender:Female
Location:New York
Vaccinated:2012-07-25
Onset:2012-07-29
Submitted:2012-08-09
Entered:2012-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C4257AA / 2 LL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F56178 / 2 RL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB207A / 2 MO / PO

Administered by: Private      Purchased by: Public
Symptoms: Haematochezia, Haematocrit decreased, Haemoglobin normal, Intussusception, Large intestinal obstruction reduction, Platelet count normal, Vomiting, White blood cell count normal, Enema administration, Ultrasound abdomen, Abdominal X-ray

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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal x-ray; Abdominal Ultrasound; CBC: WBC 8.2; Hemoglobin 10.5; Hematocrit 31; Platelet count 436
CDC 'Split Type':

Write-up: 4 days after receiving immunization developed multiple episodes of vomiting becoming bilious went to ER and was discovered to have currant jelly stools. Tx: Air enema reduction of intussusception involving the sigmoid colon.


Changed on 6/14/2018

VAERS ID: 461714 Before After
VAERS Form:1
Age:0.34
Gender:Female
Location:New York
Vaccinated:2012-07-25
Onset:2012-07-29
Submitted:2012-08-09
Entered:2012-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C4257AA / 2 LL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F56178 / 2 RL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB207A / 2 MO / PO

Administered by: Private      Purchased by: Public
Symptoms: Haematochezia, Haematocrit decreased, Haemoglobin normal, Intussusception, Large intestinal obstruction reduction, Platelet count normal, Vomiting, White blood cell count normal, Enema administration, Ultrasound abdomen, Abdominal X-ray

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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal x-ray; Abdominal Ultrasound; CBC: WBC 8.2; Hemoglobin 10.5; Hematocrit 31; Platelet count 436
CDC 'Split Type':

Write-up: 4 days after receiving immunization developed multiple episodes of vomiting becoming bilious went to ER and was discovered to have currant jelly stools. Tx: Air enema reduction of intussusception involving the sigmoid colon.


Changed on 8/14/2018

VAERS ID: 461714 Before After
VAERS Form:1
Age:0.34
Gender:Female
Location:New York
Vaccinated:2012-07-25
Onset:2012-07-29
Submitted:2012-08-09
Entered:2012-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C4257AA / 2 LL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F56178 / 2 RL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB207A / 2 MO / PO

Administered by: Private      Purchased by: Public
Symptoms: Haematochezia, Haematocrit decreased, Haemoglobin normal, Intussusception, Large intestinal obstruction reduction, Platelet count normal, Vomiting, White blood cell count normal, Enema administration, Ultrasound abdomen, Abdominal X-ray

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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal x-ray; Abdominal Ultrasound; CBC: WBC 8.2; Hemoglobin 10.5; Hematocrit 31; Platelet count 436
CDC 'Split Type':

Write-up: 4 days after receiving immunization developed multiple episodes of vomiting becoming bilious went to ER and was discovered to have currant jelly stools. Tx: Air enema reduction of intussusception involving the sigmoid colon.


Changed on 9/14/2018

VAERS ID: 461714 Before After
VAERS Form:1
Age:0.34
Gender:Female
Location:New York
Vaccinated:2012-07-25
Onset:2012-07-29
Submitted:2012-08-09
Entered:2012-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C4257AA / 2 LL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F56178 / 2 RL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB207A / 2 MO / PO

Administered by: Private      Purchased by: Public
Symptoms: Haematochezia, Haematocrit decreased, Haemoglobin normal, Intussusception, Large intestinal obstruction reduction, Platelet count normal, Vomiting, White blood cell count normal, Enema administration, Ultrasound abdomen, Abdominal X-ray

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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal x-ray; Abdominal Ultrasound; CBC: WBC 8.2; Hemoglobin 10.5; Hematocrit 31; Platelet count 436
CDC 'Split Type':

Write-up: 4 days after receiving immunization developed multiple episodes of vomiting becoming bilious went to ER and was discovered to have currant jelly stools. Tx: Air enema reduction of intussusception involving the sigmoid colon.

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