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This is VAERS ID 537517

History of Changes from the VAERS Wayback Machine

First Appeared on 8/14/2014

VAERS ID: 537517
VAERS Form:
Age:0.2
Gender:Female
Location:California
Vaccinated:2014-07-18
Onset:2014-07-21
Submitted:2014-07-23
Entered:2014-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS E2297 / 0 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UI097AA / 0 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH H45394 / 0 RL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB407A / 0 - / PO

Administered by: Public      Purchased by: Public
Symptoms: Intussusception, Enema administration, Ultrasound abdomen abnormal

Life Threatening? Yes
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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data: Ultrasound positive for intussusception and reduced via air enema.
CDC 'Split Type':

Write-up: Intussusception.


Changed on 2/14/2017

VAERS ID: 537517 Before After
VAERS Form:
Age:0.2 0.18
Gender:Female
Location:California
Vaccinated:2014-07-18
Onset:2014-07-21
Submitted:2014-07-23
Entered:2014-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS E2297 / 0 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UI097AA / 0 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH H45394 / 0 RL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB407A / 0 - / PO

Administered by: Public      Purchased by: Public
Symptoms: Intussusception, Enema administration, Ultrasound abdomen abnormal

Life Threatening? Yes
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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data: Ultrasound positive for intussusception and reduced via air enema.
CDC 'Split Type':

Write-up: Intussusception.


Changed on 9/14/2017

VAERS ID: 537517 Before After
VAERS Form:(blank) 1
Age:0.18
Gender:Female
Location:California
Vaccinated:2014-07-18
Onset:2014-07-21
Submitted:2014-07-23
Entered:2014-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS E2297 / 0 1 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UI097AA / 0 1 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH H45394 / 0 1 RL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB407A / 0 1 - MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Intussusception, Enema administration, Ultrasound abdomen abnormal

Life Threatening? Yes
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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data: Ultrasound positive for intussusception and reduced via air enema.
CDC 'Split Type':

Write-up: Intussusception.


Changed on 2/14/2018

VAERS ID: 537517 Before After
VAERS Form:1
Age:0.18
Gender:Female
Location:California
Vaccinated:2014-07-18
Onset:2014-07-21
Submitted:2014-07-23
Entered:2014-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS E2297 / 1 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UI097AA / 1 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH H45394 / 1 RL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB407A / 1 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Intussusception, Enema administration, Ultrasound abdomen abnormal

Life Threatening? Yes
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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data: Ultrasound positive for intussusception and reduced via air enema.
CDC 'Split Type':

Write-up: Intussusception.


Changed on 6/14/2018

VAERS ID: 537517 Before After
VAERS Form:1
Age:0.18
Gender:Female
Location:California
Vaccinated:2014-07-18
Onset:2014-07-21
Submitted:2014-07-23
Entered:2014-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS E2297 / 1 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UI097AA / 1 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH H45394 / 1 RL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB407A / 1 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Intussusception, Enema administration, Ultrasound abdomen abnormal

Life Threatening? Yes
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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data: Ultrasound positive for intussusception and reduced via air enema.
CDC 'Split Type':

Write-up: Intussusception.


Changed on 8/14/2018

VAERS ID: 537517 Before After
VAERS Form:1
Age:0.18
Gender:Female
Location:California
Vaccinated:2014-07-18
Onset:2014-07-21
Submitted:2014-07-23
Entered:2014-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS E2297 / 1 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UI097AA / 1 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH H45394 / 1 RL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB407A / 1 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Intussusception, Enema administration, Ultrasound abdomen abnormal

Life Threatening? Yes
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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data: Ultrasound positive for intussusception and reduced via air enema.
CDC 'Split Type':

Write-up: Intussusception.


Changed on 9/14/2018

VAERS ID: 537517 Before After
VAERS Form:1
Age:0.18
Gender:Female
Location:California
Vaccinated:2014-07-18
Onset:2014-07-21
Submitted:2014-07-23
Entered:2014-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS E2297 / 1 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UI097AA / 1 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH H45394 / 1 RL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB407A / 1 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Intussusception, Enema administration, Ultrasound abdomen abnormal

Life Threatening? Yes
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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data: Ultrasound positive for intussusception and reduced via air enema.
CDC 'Split Type':

Write-up: Intussusception.


Changed on 10/14/2018

VAERS ID: 537517 Before After
VAERS Form:1
Age:0.18
Gender:Female
Location:California
Vaccinated:2014-07-18
Onset:2014-07-21
Submitted:2014-07-23
Entered:2014-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS E2297 / 1 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UI097AA / 1 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH H45394 / 1 RL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB407A / 1 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Intussusception, Enema administration, Ultrasound abdomen abnormal

Life Threatening? Yes
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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data: Ultrasound positive for intussusception and reduced via air enema.
CDC 'Split Type':

Write-up: Intussusception.

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