National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 502837

History of Changes from the VAERS Wayback Machine

First Appeared on 10/13/2013

502837
VAERS Form:
Age:0.2
Gender:Female
Location:Maine
Vaccinated:2013-09-05
Onset:2013-09-11
Submitted:2013-09-17
Entered:2013-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C4452AA / 0 LL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. H017304 / 1 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UH807AA / 0 LL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR J1281 / 0 LL / SC
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH G43220 / 0 RL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB344A / 0 - / PO

Administered by: Private      Purchased by: Public
Symptoms: 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: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Air enema reduced
CDC 'Split Type':

Write-up:Intussusception 5 days after ROTARIX.


Changed on 2/14/2017

502837 Before After
VAERS Form:
Age:0.2 0.17
Gender:Female
Location:Maine
Vaccinated:2013-09-05
Onset:2013-09-11
Submitted:2013-09-17
Entered:2013-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C4452AA / 0 LL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. H017304 / 1 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UH807AA / 0 LL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR J1281 / 0 LL / SC
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH G43220 / 0 RL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB344A / 0 - / PO

Administered by: Private      Purchased by: Public
Symptoms: 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: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Air enema reduced
CDC 'Split Type':

Write-up:Intussusception 5 days after ROTARIX.


Changed on 9/14/2017

502837 Before After
VAERS Form:(blank) 1
Age:0.17
Gender:Female
Location:Maine
Vaccinated:2013-09-05
Onset:2013-09-11
Submitted:2013-09-17
Entered:2013-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C4452AA / 0 1 LL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. H017304 / 1 2 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UH807AA / 0 1 LL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR J1281 / 0 1 LL / SC
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH G43220 / 0 1 RL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB344A / 0 1 - MO / PO

Administered by: Private      Purchased by: Public
Symptoms: 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: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Air enema reduced
CDC 'Split Type':

Write-up:Intussusception 5 days after ROTARIX.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=502837&WAYBACKHISTORY=ON


Copyright © 2018 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166