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This is VAERS ID 527969

History of Changes from the VAERS Wayback Machine

First Appeared on 5/16/2014

VAERS ID: 527969
VAERS Form:
Age:0.2
Gender:Female
Location:Michigan
Vaccinated:2014-02-25
Onset:2014-04-02
Submitted:2014-04-08
Entered:2014-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS 7449K / 0 UN / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UH973AA / 0 UN / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH G98652 / 0 UN / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB414A / 0 - / PO

Administered by: Private      Purchased by: Public
Symptoms: Diarrhoea haemorrhagic, Intussusception, Irritability, Surgery, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: TYLENOL
Current Illness:
Preexisting Conditions: Apnea; GERD; RSV Bronchitis
Allergies:
Diagnostic Lab Data: Intussusception / Surgery
CDC 'Split Type':

Write-up: Vomiting, bloody diarrhea, fussy.


Changed on 6/14/2014

VAERS ID: 527969 Before After
VAERS Form:
Age:0.2
Gender:Female
Location:Michigan
Vaccinated:2014-02-25
Onset:2014-04-02
Submitted:2014-04-08
Entered:2014-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS 7449K / 0 UN LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UH973AA / 0 UN RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH G98652 / 0 UN RL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB414A / 0 - / PO

Administered by: Private      Purchased by: Public
Symptoms: Diarrhoea haemorrhagic, Intussusception, Irritability, Surgery, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No Yes, days: (blank) 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: TYLENOL
Current Illness:
Preexisting Conditions: Apnea; GERD; RSV Bronchitis
Allergies:
Diagnostic Lab Data: Intussusception / Surgery
CDC 'Split Type':

Write-up: Vomiting, bloody diarrhea, fussy.


Changed on 2/14/2017

VAERS ID: 527969 Before After
VAERS Form:
Age:0.2 0.17
Gender:Female
Location:Michigan
Vaccinated:2014-02-25
Onset:2014-04-02
Submitted:2014-04-08
Entered:2014-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS 7449K / 0 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UH973AA / 0 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH G98652 / 0 RL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB414A / 0 - / PO

Administered by: Private      Purchased by: Public
Symptoms: Diarrhoea haemorrhagic, Intussusception, Irritability, Surgery, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: TYLENOL
Current Illness:
Preexisting Conditions: Apnea; GERD; RSV Bronchitis
Allergies:
Diagnostic Lab Data: Intussusception / Surgery
CDC 'Split Type':

Write-up: Vomiting, bloody diarrhea, fussy.


Changed on 9/14/2017

VAERS ID: 527969 Before After
VAERS Form:(blank) 1
Age:0.17
Gender:Female
Location:Michigan
Vaccinated:2014-02-25
Onset:2014-04-02
Submitted:2014-04-08
Entered:2014-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS 7449K / 0 1 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UH973AA / 0 1 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH G98652 / 0 1 RL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB414A / 0 1 - MO / PO

Administered by: Private      Purchased by: Public
Symptoms: Diarrhoea haemorrhagic, Intussusception, Irritability, Surgery, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: TYLENOL
Current Illness:
Preexisting Conditions: Apnea; GERD; RSV Bronchitis
Allergies:
Diagnostic Lab Data: Intussusception / Surgery
CDC 'Split Type':

Write-up: Vomiting, bloody diarrhea, fussy.


Changed on 2/14/2018

VAERS ID: 527969 Before After
VAERS Form:1
Age:0.17
Gender:Female
Location:Michigan
Vaccinated:2014-02-25
Onset:2014-04-02
Submitted:2014-04-08
Entered:2014-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS 7449K / 1 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UH973AA / 1 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH G98652 / 1 RL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB414A / 1 MO / PO

Administered by: Private      Purchased by: Public
Symptoms: Diarrhoea haemorrhagic, Intussusception, Irritability, Surgery, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: TYLENOL
Current Illness:
Preexisting Conditions: Apnea; GERD; RSV Bronchitis
Allergies:
Diagnostic Lab Data: Intussusception / Surgery
CDC 'Split Type':

Write-up: Vomiting, bloody diarrhea, fussy.


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