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This is VAERS ID 462749

History of Changes from the VAERS Wayback Machine

First Appeared on 9/12/2012

VAERS ID: 462749
VAERS Form:
Age:0.2
Gender:Female
Location:Connecticut
Vaccinated:2012-08-07
Onset:2012-08-12
Submitted:2012-08-14
Entered:2012-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C419AA / 0 RL / UN
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVC093AA / 1 LL / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 918242 / 0 LL / UN
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB268A / 0 - / PO

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

Life Threatening? Yes
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: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Intussusception diagnosed at hospital 8/12/12. Reduced by barium enema at hospital. S/p vomiting & bloody stools.

Changed on 5/13/2013

VAERS ID: 462749 Before After
VAERS Form:
Age:0.2
Gender:Female
Location:Connecticut
Vaccinated:2012-08-07
Onset:2012-08-12
Submitted:2012-08-14
Entered:2012-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C419AA / 0 RL / UN
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVC093AA / 1 LL / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 918242 / 0 LL / UN
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB268A / 0 - / PO
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB268A / 0 - / PO

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

Life Threatening? Yes
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: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Intussusception diagnosed at hospital 8/12/12. Reduced by barium enema at hospital. S/p vomiting & bloody stools.

Changed on 2/14/2017

VAERS ID: 462749 Before After
VAERS Form:
Age:0.2 0.18
Gender:Female
Location:Connecticut
Vaccinated:2012-08-07
Onset:2012-08-12
Submitted:2012-08-14
Entered:2012-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C419AA / 0 RL / UN
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVC093AA / 1 LL / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 918242 / 0 LL / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB268A / 0 - / PO

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

Life Threatening? Yes
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: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Intussusception diagnosed at hospital 8/12/12. Reduced by barium enema at hospital. S/p vomiting & bloody stools.

Changed on 9/14/2017

VAERS ID: 462749 Before After
VAERS Form:(blank) 1
Age:0.18
Gender:Female
Location:Connecticut
Vaccinated:2012-08-07
Onset:2012-08-12
Submitted:2012-08-14
Entered:2012-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C419AA / 0 1 RL / UN
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVC093AA / 1 2 LL / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 918242 / 0 1 LL / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB268A / 0 1 - MO / PO

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

Life Threatening? Yes
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: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Intussusception diagnosed at hospital 8/12/12. Reduced by barium enema at hospital. S/p vomiting & bloody stools.

Changed on 2/14/2018

VAERS ID: 462749 Before After
VAERS Form:1
Age:0.18
Gender:Female
Location:Connecticut
Vaccinated:2012-08-07
Onset:2012-08-12
Submitted:2012-08-14
Entered:2012-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C419AA / 1 RL / UN
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVC093AA / 2 LL / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 918242 / 1 LL / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB268A / 1 MO / PO

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

Life Threatening? Yes
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: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Intussusception diagnosed at hospital 8/12/12. Reduced by barium enema at hospital. S/p vomiting & bloody stools.

Changed on 6/14/2018

VAERS ID: 462749 Before After
VAERS Form:1
Age:0.18
Gender:Female
Location:Connecticut
Vaccinated:2012-08-07
Onset:2012-08-12
Submitted:2012-08-14
Entered:2012-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C419AA / 1 RL / UN
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVC093AA / 2 LL / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 918242 / 1 LL / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB268A / 1 MO / PO

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

Life Threatening? Yes
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: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Intussusception diagnosed at hospital 8/12/12. Reduced by barium enema at hospital. S/p vomiting & bloody stools.

Changed on 8/14/2018

VAERS ID: 462749 Before After
VAERS Form:1
Age:0.18
Gender:Female
Location:Connecticut
Vaccinated:2012-08-07
Onset:2012-08-12
Submitted:2012-08-14
Entered:2012-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C419AA / 1 RL / UN
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVC093AA / 2 LL / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 918242 / 1 LL / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB268A / 1 MO / PO

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

Life Threatening? Yes
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: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Intussusception diagnosed at hospital 8/12/12. Reduced by barium enema at hospital. S/p vomiting & bloody stools.

Changed on 9/14/2018

VAERS ID: 462749 Before After
VAERS Form:1
Age:0.18
Gender:Female
Location:Connecticut
Vaccinated:2012-08-07
Onset:2012-08-12
Submitted:2012-08-14
Entered:2012-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C419AA / 1 RL / UN
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVC093AA / 2 LL / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 918242 / 1 LL / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB268A / 1 MO / PO

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

Life Threatening? Yes
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: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Intussusception diagnosed at hospital 8/12/12. Reduced by barium enema at hospital. S/p vomiting & bloody stools.

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