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This is VAERS ID 465859

History of Changes from the VAERS Wayback Machine

First Appeared on 10/14/2012

VAERS ID: 465859
VAERS Form:
Age:0.2
Gender:Male
Location:Kentucky
Vaccinated:2012-08-06
Onset:2012-08-13
Submitted:2012-09-20
Entered:2012-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C4257AA / 0 RL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0021AE / 1 LL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH E562922 / 0 LL / UN
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB252A / 0 - / PO

Administered by: Private      Purchased by: Public
Symptoms: Appendicectomy, Haematochezia, Intussusception, Nausea, Ultrasound scan, Vomiting, 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: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Ultrasound; X-ray
CDC 'Split Type':

Write-up: Nausea & vomiting, blood in stool. Open reduction of ileocolic intuss with incidental appendectomy.


Changed on 11/13/2012

VAERS ID: 465859 Before After
VAERS Form:
Age:0.2
Gender:Male
Location:Kentucky
Vaccinated:2012-08-06
Onset:2012-08-13
Submitted:2012-09-20
Entered:2012-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C4257AA / 0 RL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0021AE / 1 LL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH E562922 / 0 LL / UN
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB252A / 0 - / PO

Administered by: Private      Purchased by: Public
Symptoms: Appendicectomy, Haematochezia, Intussusception, Nausea, Ultrasound scan, Vomiting, 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) 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Ultrasound; X-ray
CDC 'Split Type':

Write-up: Nausea & vomiting, blood in stool. Open reduction of ileocolic intuss with incidental appendectomy.


Changed on 5/13/2013

VAERS ID: 465859 Before After
VAERS Form:
Age:0.2
Gender:Male
Location:Kentucky
Vaccinated:2012-08-06
Onset:2012-08-13
Submitted:2012-09-20
Entered:2012-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C4257AA / 0 RL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0021AE / 1 LL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH E562922 / 0 LL / UN
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB252A / 0 - / PO
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB252A / 0 - / PO

Administered by: Private      Purchased by: Public
Symptoms: Appendicectomy, Haematochezia, Intussusception, Nausea, Ultrasound scan, Vomiting, 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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Ultrasound; X-ray
CDC 'Split Type':

Write-up: Nausea & vomiting, blood in stool. Open reduction of ileocolic intuss with incidental appendectomy.


Changed on 2/14/2017

VAERS ID: 465859 Before After
VAERS Form:
Age:0.2 0.18
Gender:Male
Location:Kentucky
Vaccinated:2012-08-06
Onset:2012-08-13
Submitted:2012-09-20
Entered:2012-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C4257AA / 0 RL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0021AE / 1 LL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH E562922 / 0 LL / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB252A / 0 - / PO

Administered by: Private      Purchased by: Public
Symptoms: Appendicectomy, Haematochezia, Intussusception, Nausea, Ultrasound scan, Vomiting, 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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Ultrasound; X-ray
CDC 'Split Type':

Write-up: Nausea & vomiting, blood in stool. Open reduction of ileocolic intuss with incidental appendectomy.


Changed on 9/14/2017

VAERS ID: 465859 Before After
VAERS Form:(blank) 1
Age:0.18
Gender:Male
Location:Kentucky
Vaccinated:2012-08-06
Onset:2012-08-13
Submitted:2012-09-20
Entered:2012-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C4257AA / 0 1 RL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0021AE / 1 2 LL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH E562922 / 0 1 LL / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB252A / 0 1 - MO / PO

Administered by: Private      Purchased by: Public
Symptoms: Appendicectomy, Haematochezia, Intussusception, Nausea, Ultrasound scan, Vomiting, 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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Ultrasound; X-ray
CDC 'Split Type':

Write-up: Nausea & vomiting, blood in stool. Open reduction of ileocolic intuss with incidental appendectomy.


Changed on 2/14/2018

VAERS ID: 465859 Before After
VAERS Form:1
Age:0.18
Gender:Male
Location:Kentucky
Vaccinated:2012-08-06
Onset:2012-08-13
Submitted:2012-09-20
Entered:2012-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C4257AA / 1 RL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0021AE / 2 LL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH E562922 / 1 LL / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB252A / 1 MO / PO

Administered by: Private      Purchased by: Public
Symptoms: Appendicectomy, Haematochezia, Intussusception, Nausea, Ultrasound scan, Vomiting, 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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Ultrasound; X-ray
CDC 'Split Type':

Write-up: Nausea & vomiting, blood in stool. Open reduction of ileocolic intuss with incidental appendectomy.


Changed on 6/14/2018

VAERS ID: 465859 Before After
VAERS Form:1
Age:0.18
Gender:Male
Location:Kentucky
Vaccinated:2012-08-06
Onset:2012-08-13
Submitted:2012-09-20
Entered:2012-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C4257AA / 1 RL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0021AE / 2 LL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH E562922 / 1 LL / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB252A / 1 MO / PO

Administered by: Private      Purchased by: Public
Symptoms: Appendicectomy, Haematochezia, Intussusception, Nausea, Ultrasound scan, Vomiting, 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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Ultrasound; X-ray
CDC 'Split Type':

Write-up: Nausea & vomiting, blood in stool. Open reduction of ileocolic intuss with incidental appendectomy.


Changed on 8/14/2018

VAERS ID: 465859 Before After
VAERS Form:1
Age:0.18
Gender:Male
Location:Kentucky
Vaccinated:2012-08-06
Onset:2012-08-13
Submitted:2012-09-20
Entered:2012-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C4257AA / 1 RL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0021AE / 2 LL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH E562922 / 1 LL / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB252A / 1 MO / PO

Administered by: Private      Purchased by: Public
Symptoms: Appendicectomy, Haematochezia, Intussusception, Nausea, Ultrasound scan, Vomiting, 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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Ultrasound; X-ray
CDC 'Split Type':

Write-up: Nausea & vomiting, blood in stool. Open reduction of ileocolic intuss with incidental appendectomy.


Changed on 9/14/2018

VAERS ID: 465859 Before After
VAERS Form:1
Age:0.18
Gender:Male
Location:Kentucky
Vaccinated:2012-08-06
Onset:2012-08-13
Submitted:2012-09-20
Entered:2012-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C4257AA / 1 RL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0021AE / 2 LL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH E562922 / 1 LL / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB252A / 1 MO / PO

Administered by: Private      Purchased by: Public
Symptoms: Appendicectomy, Haematochezia, Intussusception, Nausea, Ultrasound scan, Vomiting, 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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Ultrasound; X-ray
CDC 'Split Type':

Write-up: Nausea & vomiting, blood in stool. Open reduction of ileocolic intuss with incidental appendectomy.

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