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This is VAERS ID 539638

History of Changes from the VAERS Wayback Machine

First Appeared on 8/14/2014

VAERS ID: 539638
VAERS Form:
Age:0.4
Gender:Male
Location:Louisiana
Vaccinated:2014-07-24
Onset:2014-07-26
Submitted:2014-08-12
Entered:2014-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS 9EA47 / 1 RL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. K001124 / 1 LL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH H45100 / 1 LL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41CB418A / 1 - / PO

Administered by: Private      Purchased by: Public
Symptoms: Barium enema, Crying, Intussusception, Irritability, Vomiting, Enema administration, Computerised tomogram 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: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: CT scan - abd.
CDC 'Split Type':

Write-up: Presented to E.R. on 7/26 evening with hx of crying, irritability and bilious vomiting 15 x''s approx. 10-12 hrs. Workup/CT abd revealed intussusception 5-6cm. A.M. of 7/27 pt. was transferred to hosp. via ambulance. Barium enema performed and intussusception resolved without surgery. D/c''d home on 7/28/14.


Changed on 2/14/2017

VAERS ID: 539638 Before After
VAERS Form:
Age:0.4 0.35
Gender:Male
Location:Louisiana
Vaccinated:2014-07-24
Onset:2014-07-26
Submitted:2014-08-12
Entered:2014-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS 9EA47 / 1 RL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. K001124 / 1 LL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH H45100 / 1 LL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41CB418A / 1 - / PO

Administered by: Private      Purchased by: Public
Symptoms: Barium enema, Crying, Intussusception, Irritability, Vomiting, Enema administration, Computerised tomogram 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: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: CT scan - abd.
CDC 'Split Type':

Write-up: Presented to E.R. on 7/26 evening with hx of crying, irritability and bilious vomiting 15 x''s approx. 10-12 hrs. Workup/CT abd revealed intussusception 5-6cm. A.M. of 7/27 pt. was transferred to hosp. via ambulance. Barium enema performed and intussusception resolved without surgery. D/c''d home on 7/28/14.


Changed on 9/14/2017

VAERS ID: 539638 Before After
VAERS Form:(blank) 1
Age:0.35
Gender:Male
Location:Louisiana
Vaccinated:2014-07-24
Onset:2014-07-26
Submitted:2014-08-12
Entered:2014-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS 9EA47 / 1 2 RL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. K001124 / 1 2 LL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH H45100 / 1 2 LL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41CB418A / 1 2 - MO / PO

Administered by: Private      Purchased by: Public
Symptoms: Barium enema, Crying, Intussusception, Irritability, Vomiting, Enema administration, Computerised tomogram 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: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: CT scan - abd.
CDC 'Split Type':

Write-up: Presented to E.R. on 7/26 evening with hx of crying, irritability and bilious vomiting 15 x''s approx. 10-12 hrs. Workup/CT abd revealed intussusception 5-6cm. A.M. of 7/27 pt. was transferred to hosp. via ambulance. Barium enema performed and intussusception resolved without surgery. D/c''d home on 7/28/14.


Changed on 2/14/2018

VAERS ID: 539638 Before After
VAERS Form:1
Age:0.35
Gender:Male
Location:Louisiana
Vaccinated:2014-07-24
Onset:2014-07-26
Submitted:2014-08-12
Entered:2014-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS 9EA47 / 2 RL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. K001124 / 2 LL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH H45100 / 2 LL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41CB418A / 2 MO / PO

Administered by: Private      Purchased by: Public
Symptoms: Barium enema, Crying, Intussusception, Irritability, Vomiting, Enema administration, Computerised tomogram 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: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: CT scan - abd.
CDC 'Split Type':

Write-up: Presented to E.R. on 7/26 evening with hx of crying, irritability and bilious vomiting 15 x''s approx. 10-12 hrs. Workup/CT abd revealed intussusception 5-6cm. A.M. of 7/27 pt. was transferred to hosp. via ambulance. Barium enema performed and intussusception resolved without surgery. D/c''d home on 7/28/14.


Changed on 6/14/2018

VAERS ID: 539638 Before After
VAERS Form:1
Age:0.35
Gender:Male
Location:Louisiana
Vaccinated:2014-07-24
Onset:2014-07-26
Submitted:2014-08-12
Entered:2014-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS 9EA47 / 2 RL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. K001124 / 2 LL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH H45100 / 2 LL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41CB418A / 2 MO / PO

Administered by: Private      Purchased by: Public
Symptoms: Barium enema, Crying, Intussusception, Irritability, Vomiting, Enema administration, Computerised tomogram 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: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: CT scan - abd.
CDC 'Split Type':

Write-up: Presented to E.R. on 7/26 evening with hx of crying, irritability and bilious vomiting 15 x''s approx. 10-12 hrs. Workup/CT abd revealed intussusception 5-6cm. A.M. of 7/27 pt. was transferred to hosp. via ambulance. Barium enema performed and intussusception resolved without surgery. D/c''d home on 7/28/14.

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