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This is VAERS ID 522516

History of Changes from the VAERS Wayback Machine

First Appeared on 3/14/2014

VAERS ID: 522516
VAERS Form:
Age:0.3
Gender:Female
Location:California
Vaccinated:2014-02-05
Onset:2014-02-09
Submitted:2014-02-12
Entered:2014-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS 7449K / - LL / UN
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UH976AA / - LL / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH G75064 / - RL / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41CB396A / 1 - / PO

Administered by: Private      Purchased by: Other
Symptoms: Barium enema, Intussusception, Vomiting, Enema administration, Ultrasound abdomen abnormal

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: None
Allergies:
Diagnostic Lab Data: Abdmoinal ultrasound and barium enema
CDC 'Split Type':

Write-up: Patient was diagnosed with intussusception via abdominal ultrasound; she presented with billous vomiting for 2 days and was then admitted to Medical Center, where she was diagnosed by myself. While in the hospital she had a barium enema reduction of the intussusception that reduced the ailment without surgery. Patient was discharged the next day in stable condition. She was found to have the Rotavirus vaccine (as well as her other 2 month vaccines) given on 02/05/2014 by her PMD.


Changed on 9/14/2017

VAERS ID: 522516 Before After
VAERS Form:(blank) 1
Age:0.3
Gender:Female
Location:California
Vaccinated:2014-02-05
Onset:2014-02-09
Submitted:2014-02-12
Entered:2014-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS 7449K / - UNK LL / UN
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UH976AA / - UNK LL / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH G75064 / - UNK RL / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41CB396A / 1 2 - MO / PO

Administered by: Private      Purchased by: Other
Symptoms: Barium enema, Intussusception, Vomiting, Enema administration, Ultrasound abdomen abnormal

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: None
Allergies:
Diagnostic Lab Data: Abdmoinal ultrasound and barium enema
CDC 'Split Type':

Write-up: Patient was diagnosed with intussusception via abdominal ultrasound; she presented with billous vomiting for 2 days and was then admitted to Medical Center, where she was diagnosed by myself. While in the hospital she had a barium enema reduction of the intussusception that reduced the ailment without surgery. Patient was discharged the next day in stable condition. She was found to have the Rotavirus vaccine (as well as her other 2 month vaccines) given on 02/05/2014 by her PMD.


Changed on 2/14/2018

VAERS ID: 522516 Before After
VAERS Form:1
Age:0.3
Gender:Female
Location:California
Vaccinated:2014-02-05
Onset:2014-02-09
Submitted:2014-02-12
Entered:2014-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS 7449K / UNK LL / UN
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UH976AA / UNK LL / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH G75064 / UNK RL / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41CB396A / 2 MO / PO

Administered by: Private      Purchased by: Other
Symptoms: Barium enema, Intussusception, Vomiting, Enema administration, Ultrasound abdomen abnormal

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: None
Allergies:
Diagnostic Lab Data: Abdmoinal ultrasound and barium enema
CDC 'Split Type':

Write-up: Patient was diagnosed with intussusception via abdominal ultrasound; she presented with billous vomiting for 2 days and was then admitted to Medical Center, where she was diagnosed by myself. While in the hospital she had a barium enema reduction of the intussusception that reduced the ailment without surgery. Patient was discharged the next day in stable condition. She was found to have the Rotavirus vaccine (as well as her other 2 month vaccines) given on 02/05/2014 by her PMD.


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