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This is VAERS ID 524961

History of Changes from the VAERS Wayback Machine

First Appeared on 3/14/2014

VAERS ID: 524961
VAERS Form:
Age:0.2
Gender:Female
Location:Mississippi
Vaccinated:2014-02-26
Onset:2014-03-01
Submitted:2014-03-06
Entered:2014-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB401A / 0 - / PO

Administered by: Private      Purchased by: Public
Symptoms: Intussusception, Rash, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data: Done in ED
CDC 'Split Type':

Write-up: Intussusception 3/1 - 3/2/ 2014. Enema reduction. ? Rash on the face 24 hours after vaccine. Resolved in 2 days.


Changed on 4/14/2014

VAERS ID: 524961 Before After
VAERS Form:
Age:0.2
Gender:Female
Location:Mississippi
Vaccinated:2014-02-26
Onset:2014-03-01
Submitted:2014-03-06
Entered:2014-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS 7537C / 0 - / -
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UH997AA / 0 - / -
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. H00137 / 0 - / -
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB401A / 0 - / PO

Administered by: Private      Purchased by: Public
Symptoms: Intussusception, Rash, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data: Done in ED
CDC 'Split Type':

Write-up: Intussusception 3/1 - 3/2/ 2014. Enema reduction. ? Rash on the face 24 hours after vaccine. Resolved in 2 days.


Changed on 6/14/2014

VAERS ID: 524961 Before After
VAERS Form:
Age:0.2
Gender:Female
Location:Mississippi
Vaccinated:2014-02-26
Onset:2014-03-01
Submitted:2014-03-06
Entered:2014-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS 7537C / 0 - / -
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UH997AA / 0 - / -
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. H00137 / 0 - / -
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB401A / 0 - / PO

Administered by: Private      Purchased by: Public
Symptoms: Intussusception, Rash, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data: Done in ED
CDC 'Split Type':

Write-up: Intussusception 3/1 - 3/2/ 2014. Enema reduction. ? Rash on the face 24 hours after vaccine. Resolved in 2 days.


Changed on 3/14/2015

VAERS ID: 524961 Before After
VAERS Form:
Age:0.2
Gender:Female
Location:Mississippi
Vaccinated:2014-02-26
Onset:2014-03-01
Submitted:2014-03-06
Entered:2014-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS 7537C / 0 - / -
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UH997AA / 0 - / -
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. H00137 / 0 - / -
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB401A / 0 - / PO

Administered by: Private      Purchased by: Public
Symptoms: Intussusception, Rash, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data: Done in ED
CDC 'Split Type':

Write-up: Intussusception 3/1 - 3/2/ 2014. Enema reduction. ? Rash on the face 24 hours after vaccine. Resolved in 2 days.


Changed on 2/14/2017

VAERS ID: 524961 Before After
VAERS Form:
Age:0.2 0.17
Gender:Female
Location:Mississippi
Vaccinated:2014-02-26
Onset:2014-03-01
Submitted:2014-03-06
Entered:2014-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS 7537C / 0 - / -
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UH997AA / 0 - / -
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. H00137 / 0 - / -
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB401A / 0 - / PO

Administered by: Private      Purchased by: Public
Symptoms: Intussusception, Rash, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data: Done in ED
CDC 'Split Type':

Write-up: Intussusception 3/1 - 3/2/ 2014. Enema reduction. ? Rash on the face 24 hours after vaccine. Resolved in 2 days.


Changed on 9/14/2017

VAERS ID: 524961 Before After
VAERS Form:(blank) 1
Age:0.17
Gender:Female
Location:Mississippi
Vaccinated:2014-02-26
Onset:2014-03-01
Submitted:2014-03-06
Entered:2014-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS 7537C / 0 1 - / -
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UH997AA / 0 1 - / -
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. H00137 / 0 1 - / -
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB401A / 0 1 - MO / PO

Administered by: Private      Purchased by: Public
Symptoms: Intussusception, Rash, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data: Done in ED
CDC 'Split Type':

Write-up: Intussusception 3/1 - 3/2/ 2014. Enema reduction. ? Rash on the face 24 hours after vaccine. Resolved in 2 days.


Changed on 2/14/2018

VAERS ID: 524961 Before After
VAERS Form:1
Age:0.17
Gender:Female
Location:Mississippi
Vaccinated:2014-02-26
Onset:2014-03-01
Submitted:2014-03-06
Entered:2014-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS 7537C / 1 - / -
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UH997AA / 1 - / -
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. H00137 / 1 - / -
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB401A / 1 MO / PO

Administered by: Private      Purchased by: Public
Symptoms: Intussusception, Rash, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data: Done in ED
CDC 'Split Type':

Write-up: Intussusception 3/1 - 3/2/ 2014. Enema reduction. ? Rash on the face 24 hours after vaccine. Resolved in 2 days.


Changed on 6/14/2018

VAERS ID: 524961 Before After
VAERS Form:1
Age:0.17
Gender:Female
Location:Mississippi
Vaccinated:2014-02-26
Onset:2014-03-01
Submitted:2014-03-06
Entered:2014-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS 7537C / 1 - / -
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UH997AA / 1 - / -
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. H00137 / 1 - / -
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB401A / 1 MO / PO

Administered by: Private      Purchased by: Public
Symptoms: Intussusception, Rash, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data: Done in ED
CDC 'Split Type':

Write-up: Intussusception 3/1 - 3/2/ 2014. Enema reduction. ? Rash on the face 24 hours after vaccine. Resolved in 2 days.

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