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This is VAERS ID 531100

History of Changes from the VAERS Wayback Machine

First Appeared on 5/16/2014

VAERS ID: 531100
VAERS Form:
Age:0.3
Gender:Male
Location:Georgia
Vaccinated:2014-04-24
Onset:2014-04-29
Submitted:2014-05-16
Entered:2014-05-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS ML5D7 / 1 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UH832AB / 1 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH H45098 / 1 LL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB412A / 1 - / PO

Administered by: Private      Purchased by: Private
Symptoms: Crying, Haematochezia, Intussusception

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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Intussusception
CDC 'Split Type':

Write-up: Pt. mom states bloody stool, uncontrollable crying.


Changed on 2/14/2017

VAERS ID: 531100 Before After
VAERS Form:
Age:0.3 0.34
Gender:Male
Location:Georgia
Vaccinated:2014-04-24
Onset:2014-04-29
Submitted:2014-05-16
Entered:2014-05-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS ML5D7 / 1 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UH832AB / 1 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH H45098 / 1 LL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB412A / 1 - / PO

Administered by: Private      Purchased by: Private
Symptoms: Crying, Haematochezia, Intussusception

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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Intussusception
CDC 'Split Type':

Write-up: Pt. mom states bloody stool, uncontrollable crying.


Changed on 9/14/2017

VAERS ID: 531100 Before After
VAERS Form:(blank) 1
Age:0.34
Gender:Male
Location:Georgia
Vaccinated:2014-04-24
Onset:2014-04-29
Submitted:2014-05-16
Entered:2014-05-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS ML5D7 / 1 2 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UH832AB / 1 2 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH H45098 / 1 2 LL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB412A / 1 2 - MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Crying, Haematochezia, Intussusception

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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Intussusception
CDC 'Split Type':

Write-up: Pt. mom states bloody stool, uncontrollable crying.


Changed on 2/14/2018

VAERS ID: 531100 Before After
VAERS Form:1
Age:0.34
Gender:Male
Location:Georgia
Vaccinated:2014-04-24
Onset:2014-04-29
Submitted:2014-05-16
Entered:2014-05-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS ML5D7 / 2 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UH832AB / 2 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH H45098 / 2 LL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB412A / 2 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Crying, Haematochezia, Intussusception

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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Intussusception
CDC 'Split Type':

Write-up: Pt. mom states bloody stool, uncontrollable crying.


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