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History of Changes from the VAERS Wayback Machine |
First Appeared on 8/12/2013 |
VAERS ID: | 497444 |
VAERS Form: | |
Age: | 0.2 |
Gender: | Male |
Location: | Michigan |
Vaccinated: | 2013-06-03 |
Onset: | 2013-07-20 |
Submitted: | 2013-07-23 |
Entered: | 2013-07-23 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS | AC18421AA / 2 | UN / UN |
HEP: HEP B (NO BRAND NAME) / UNKNOWN MANUFACTURER | - / 1 | UN / UN |
HIBV: HIB (ACTHIB) / SANOFI PASTEUR | UH765AB / - | UN / UN |
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER | - / - | UN / UN |
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH | G04774 / - | UN / UN |
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS | A41FB344A / - | UN / UN |
Administered by: Public Purchased by: Other
Symptoms: Dehydration, Intussusception, Vomiting, X-ray normal, Enema administration, Ultrasound abdomen abnormal, Urine output decreased, 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: 2
Write-up: Patient had vomiting for a day with every feed, decreased urine output, severe dehydration. Started on 7/20, for about 10 episodes before - hospitalization. U/S abd - Intussusception. Got enema reduction and f/u x-ray showed no intussusception. He recovered after enema.
Vaccinated: | 2013-06-03 |
Onset: | 2013-07-20 |
Submitted: | 2013-07-23 |
Entered: | 2013-07-23 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS | AC18421AA / 2 | UN / UN |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B421AA / 0 | LL / IM |
HEP: HEP B (NO BRAND NAME) / UNKNOWN MANUFACTURER | - / 1 | UN / UN |
HIBV: HIB (ACTHIB) / SANOFI PASTEUR | UH765AB / - 0 | UN LL / UN IM |
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER | - / - | UN / UN |
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH | G04774 / - 0 | UN RL / UN IM |
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS | A41FB344A / - 0 | UN - / UN PO |
Administered by: Public Purchased by: Other
Symptoms: Dehydration, Intussusception, Vomiting, X-ray normal, Enema administration, Ultrasound abdomen abnormal, Urine output decreased, 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: 2 1
Write-up: Patient had vomiting for a day with every feed, decreased urine output, severe dehydration. Started on 7/20, for about 10 episodes before - hospitalization. U/S abd - Intussusception. Got enema reduction and f/u x-ray showed no intussusception. He recovered after enema.
Vaccinated: | 2013-06-03 |
Onset: | 2013-07-20 |
Submitted: | 2013-07-23 |
Entered: | 2013-07-23 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B421AA / 0 | LL / IM |
HIBV: HIB (ACTHIB) / SANOFI PASTEUR | UH765AB / 0 | LL / IM |
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH | G04774 / 0 | RL / IM |
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS | A41FB344A / 0 | - / PO |
Administered by: Public Purchased by: Other
Symptoms: Dehydration, Intussusception, Vomiting, X-ray normal, Enema administration, Ultrasound abdomen abnormal, Urine output decreased, 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
Write-up: Patient had vomiting for a day with every feed, decreased urine output, severe dehydration. Started on 7/20, for about 10 episodes before - hospitalization. U/S abd - Intussusception. Got enema reduction and f/u x-ray showed no intussusception. He recovered after enema.
Vaccinated: | 2013-06-03 |
Onset: | 2013-07-20 |
Submitted: | 2013-07-23 |
Entered: | 2013-07-23 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B421AA / 0 1 | LL / IM |
HIBV: HIB (ACTHIB) / SANOFI PASTEUR | UH765AB / 0 1 | LL / IM |
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH | G04774 / 0 1 | RL / IM |
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS | A41FB344A / 0 1 | - MO / PO |
Administered by: Public Purchased by: Other
Symptoms: Dehydration, Intussusception, Vomiting, X-ray normal, Enema administration, Ultrasound abdomen abnormal, Urine output decreased, 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
Write-up: Patient had vomiting for a day with every feed, decreased urine output, severe dehydration. Started on 7/20, for about 10 episodes before - hospitalization. U/S abd - Intussusception. Got enema reduction and f/u x-ray showed no intussusception. He recovered after enema.
Vaccinated: | 2013-06-03 |
Onset: | 2013-07-20 |
Submitted: | 2013-07-23 |
Entered: | 2013-07-23 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B421AA / 1 | LL / IM |
HIBV: HIB (ACTHIB) / SANOFI PASTEUR | UH765AB / 1 | LL / IM |
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH | G04774 / 1 | RL / IM |
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS | A41FB344A / 1 | MO / PO |
Administered by: Public Purchased by: Other
Symptoms: Dehydration, Intussusception, Vomiting, X-ray normal, Enema administration, Ultrasound abdomen abnormal, Urine output decreased, 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
Write-up: Patient had vomiting for a day with every feed, decreased urine output, severe dehydration. Started on 7/20, for about 10 episodes before - hospitalization. U/S abd - Intussusception. Got enema reduction and f/u x-ray showed no intussusception. He recovered after enema.
Link To This Search Result:
http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=497444&WAYBACKHISTORY=ON
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