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This is VAERS ID 422268

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History of Changes from the VAERS Wayback Machine

First Appeared on 5/13/2011

VAERS ID: 422268
VAERS Form:
Age:0.8
Sex:Male
Location:Texas
Vaccinated:2011-02-17
Onset:2011-02-18
Submitted:0000-00-00
Entered:2011-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER AC20B172AA / 3 UN / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 915192 / 3 UN / UN

Administered by: Private      Purchased by: Private
Symptoms: Crying, Death, Pyrexia, Somnolence, Decreased appetite, Infantile spitting up

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-02-23
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Ear infection
Preexisting Conditions: Immunology problems undiagnosed
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: He was administered the shot and by the next day started having fevers & spitting up his food. His fever got worse and his appetite also. He was sleeping & crying for the most part and his fever was being stabilized by MOTRIN and TYLENOL.


Changed on 6/11/2011

VAERS ID: 422268 Before After
VAERS Form:
Age:0.8
Sex:Male
Location:Texas
Vaccinated:2011-02-17
Onset:2011-02-18
Submitted:0000-00-00
Entered:2011-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER AC20B172AA / 3 UN / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 915192 / 3 UN / UN

Administered by: Private      Purchased by: Private
Symptoms: Areflexia, Bacteraemia, Chest pain, Chest X-ray abnormal, Corneal reflex decreased, Cough, Crying, Death, Differential white blood cell count abnormal, Dyspnoea, Ear pain, Headache, Hypopnoea, Hypotension, Hypotonia, Influenza, Irritability, Lethargy, Malaise, Mydriasis, Nasal congestion, Night sweats, Oral candidiasis, Pain, Poor peripheral circulation, Pupillary reflex impaired, Pyrexia, Respiratory failure, Rhinorrhoea, Septic shock, Somnolence, Wheezing, White blood cell count increased, Brain oedema, Brain death, Shock haemorrhagic, Basophil percentage decreased, Eosinophil percentage decreased, Neutrophil percentage decreased, Neurological examination abnormal, Immunology test abnormal, Decreased appetite, Immunodeficiency, Infantile spitting up, Mechanical ventilation, Endotracheal intubation, Oropharyngeal pain, Granulocyte percentage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-02-23
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Ear infection
Preexisting Conditions: Immunology problems undiagnosed
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: He was administered the shot and by the next day started having fevers & spitting up his food. His fever got worse and his appetite also. He was sleeping & crying for the most part and his fever was being stabilized by MOTRIN and TYLENOL.


Changed on 7/12/2011

VAERS ID: 422268 Before After
VAERS Form:
Age:0.8
Sex:Male
Location:Texas
Vaccinated:2011-02-17
Onset:2011-02-18
Submitted:0000-00-00
Entered:2011-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER AC20B172AA / 3 UN / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 915192 / 3 UN / UN

Administered by: Private      Purchased by: Private
Symptoms: Areflexia, Bacteraemia, Chest pain, Chest X-ray abnormal, Corneal reflex decreased, Cough, Crying, Death, Differential white blood cell count abnormal, Dyspnoea, Ear pain, Headache, Hypopnoea, Hypotension, Hypotonia, Influenza, Irritability, Lethargy, Malaise, Mydriasis, Nasal congestion, Night sweats, Oral candidiasis, Pain, Poor peripheral circulation, Pupillary reflex impaired, Pyrexia, Respiratory failure, Rhinorrhoea, Septic shock, Somnolence, Wheezing, White blood cell count increased, Brain oedema, Brain death, Shock haemorrhagic, Basophil percentage decreased, Eosinophil percentage decreased, Neutrophil percentage decreased, Neurological examination abnormal, Immunology test abnormal, Decreased appetite, Immunodeficiency, Infantile spitting up, Mechanical ventilation, Endotracheal intubation, Oropharyngeal pain, Granulocyte percentage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-02-23
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Ear infection
Preexisting Conditions: Immunology problems undiagnosed
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: He was administered the shot and by the next day started having fevers & spitting up his food. His fever got worse and his appetite also. He was sleeping & crying for the most part and his fever was being stabilized by MOTRIN and TYLENOL.


Changed on 8/14/2014

VAERS ID: 422268 Before After
VAERS Form:
Age:0.8
Sex:Male
Location:Texas
Vaccinated:2011-02-17
Onset:2011-02-18
Submitted:0000-00-00
Entered:2011-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) DTAP (INFANRIX) / UNKNOWN MANUFACTURER GLAXOSMITHKLINE BIOLOGICALS AC20B172AA / 3 UN / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 915192 / 3 UN / UN

Administered by: Private      Purchased by: Private
Symptoms: Crying, Death, Pyrexia, Somnolence, Decreased appetite, Infantile spitting up

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-02-23
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Ear infection
Preexisting Conditions: Immunology problems undiagnosed
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: He was administered the shot and by the next day started having fevers & spitting up his food. His fever got worse and his appetite also. He was sleeping & crying for the most part and his fever was being stabilized by MOTRIN and TYLENOL.


Changed on 2/14/2017

VAERS ID: 422268 Before After
VAERS Form:
Age:0.8 0.82
Sex:Male
Location:Texas
Vaccinated:2011-02-17
Onset:2011-02-18
Submitted:0000-00-00
Entered:2011-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS AC20B172AA / 3 UN / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 915192 / 3 UN / UN

Administered by: Private      Purchased by: Private
Symptoms: Crying, Death, Pyrexia, Somnolence, Decreased appetite, Infantile spitting up

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-02-23
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Ear infection
Preexisting Conditions: Immunology problems undiagnosed
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: He was administered the shot and by the next day started having fevers & spitting up his food. His fever got worse and his appetite also. He was sleeping & crying for the most part and his fever was being stabilized by MOTRIN and TYLENOL.


Changed on 9/14/2017

VAERS ID: 422268 Before After
VAERS Form:(blank) 1
Age:0.82
Sex:Male
Location:Texas
Vaccinated:2011-02-17
Onset:2011-02-18
Submitted:0000-00-00
Entered:2011-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS AC20B172AA / 3 4 UN / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 915192 / 3 4 UN / UN

Administered by: Private      Purchased by: Private
Symptoms: Crying, Death, Pyrexia, Somnolence, Decreased appetite, Infantile spitting up

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-02-23
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Ear infection
Preexisting Conditions: Immunology problems undiagnosed
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: He was administered the shot and by the next day started having fevers & spitting up his food. His fever got worse and his appetite also. He was sleeping & crying for the most part and his fever was being stabilized by MOTRIN and TYLENOL.


Changed on 2/14/2018

VAERS ID: 422268 Before After
VAERS Form:1
Age:0.82
Sex:Male
Location:Texas
Vaccinated:2011-02-17
Onset:2011-02-18
Submitted:0000-00-00
Entered:2011-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS AC20B172AA / 4 UN / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 915192 / 4 UN / UN

Administered by: Private      Purchased by: Private
Symptoms: Crying, Death, Pyrexia, Somnolence, Decreased appetite, Infantile spitting up

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-02-23
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Ear infection
Preexisting Conditions: Immunology problems undiagnosed
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: He was administered the shot and by the next day started having fevers & spitting up his food. His fever got worse and his appetite also. He was sleeping & crying for the most part and his fever was being stabilized by MOTRIN and TYLENOL.


Changed on 6/14/2018

VAERS ID: 422268 Before After
VAERS Form:1
Age:0.82
Sex:Male
Location:Texas
Vaccinated:2011-02-17
Onset:2011-02-18
Submitted:0000-00-00
Entered:2011-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS AC20B172AA / 4 UN / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 915192 / 4 UN / UN

Administered by: Private      Purchased by: Private
Symptoms: Crying, Death, Pyrexia, Somnolence, Decreased appetite, Infantile spitting up

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-02-23
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Ear infection
Preexisting Conditions: Immunology problems undiagnosed
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: He was administered the shot and by the next day started having fevers & spitting up his food. His fever got worse and his appetite also. He was sleeping & crying for the most part and his fever was being stabilized by MOTRIN and TYLENOL.


Changed on 8/14/2018

VAERS ID: 422268 Before After
VAERS Form:1
Age:0.82
Sex:Male
Location:Texas
Vaccinated:2011-02-17
Onset:2011-02-18
Submitted:0000-00-00
Entered:2011-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS AC20B172AA / 4 UN / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 915192 / 4 UN / UN

Administered by: Private      Purchased by: Private
Symptoms: Crying, Death, Pyrexia, Somnolence, Decreased appetite, Infantile spitting up

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-02-23
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Ear infection
Preexisting Conditions: Immunology problems undiagnosed
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: He was administered the shot and by the next day started having fevers & spitting up his food. His fever got worse and his appetite also. He was sleeping & crying for the most part and his fever was being stabilized by MOTRIN and TYLENOL.


Changed on 9/14/2018

VAERS ID: 422268 Before After
VAERS Form:1
Age:0.82
Sex:Male
Location:Texas
Vaccinated:2011-02-17
Onset:2011-02-18
Submitted:0000-00-00
Entered:2011-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS AC20B172AA / 4 UN / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 915192 / 4 UN / UN

Administered by: Private      Purchased by: Private
Symptoms: Crying, Death, Pyrexia, Somnolence, Decreased appetite, Infantile spitting up

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-02-23
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Ear infection
Preexisting Conditions: Immunology problems undiagnosed
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: He was administered the shot and by the next day started having fevers & spitting up his food. His fever got worse and his appetite also. He was sleeping & crying for the most part and his fever was being stabilized by MOTRIN and TYLENOL.


Changed on 10/14/2018

VAERS ID: 422268 Before After
VAERS Form:1
Age:0.82
Sex:Male
Location:Texas
Vaccinated:2011-02-17
Onset:2011-02-18
Submitted:0000-00-00
Entered:2011-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS AC20B172AA / 4 UN / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 915192 / 4 UN / UN

Administered by: Private      Purchased by: Private
Symptoms: Crying, Death, Pyrexia, Somnolence, Decreased appetite, Infantile spitting up

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-02-23
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Ear infection
Preexisting Conditions: Immunology problems undiagnosed
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: He was administered the shot and by the next day started having fevers & spitting up his food. His fever got worse and his appetite also. He was sleeping & crying for the most part and his fever was being stabilized by MOTRIN and TYLENOL.


Changed on 12/24/2020

VAERS ID: 422268 Before After
VAERS Form:1
Age:0.82
Sex:Male
Location:Texas
Vaccinated:2011-02-17
Onset:2011-02-18
Submitted:0000-00-00
Entered:2011-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS AC20B172AA / 4 UN / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 915192 / 4 UN / UN

Administered by: Private      Purchased by: Private
Symptoms: Crying, Death, Pyrexia, Somnolence, Decreased appetite, Infantile spitting up

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-02-23
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Ear infection
Preexisting Conditions: Immunology problems undiagnosed
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: He was administered the shot and by the next day started having fevers & spitting up his food. His fever got worse and his appetite also. He was sleeping & crying for the most part and his fever was being stabilized by MOTRIN and TYLENOL.


Changed on 12/30/2020

VAERS ID: 422268 Before After
VAERS Form:1
Age:0.82
Sex:Male
Location:Texas
Vaccinated:2011-02-17
Onset:2011-02-18
Submitted:0000-00-00
Entered:2011-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS AC20B172AA / 4 UN / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 915192 / 4 UN / UN

Administered by: Private      Purchased by: Private
Symptoms: Crying, Death, Pyrexia, Somnolence, Decreased appetite, Infantile spitting up

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-02-23
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Ear infection
Preexisting Conditions: Immunology problems undiagnosed
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: He was administered the shot and by the next day started having fevers & spitting up his food. His fever got worse and his appetite also. He was sleeping & crying for the most part and his fever was being stabilized by MOTRIN and TYLENOL.


Changed on 5/7/2021

VAERS ID: 422268 Before After
VAERS Form:1
Age:0.82
Sex:Male
Location:Texas
Vaccinated:2011-02-17
Onset:2011-02-18
Submitted:0000-00-00
Entered:2011-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS AC20B172AA / 4 UN / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 915192 / 4 UN / UN

Administered by: Private      Purchased by: Private
Symptoms: Crying, Death, Pyrexia, Somnolence, Decreased appetite, Infantile spitting up

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-02-23
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Ear infection
Preexisting Conditions: Immunology problems undiagnosed
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: He was administered the shot and by the next day started having fevers & spitting up his food. His fever got worse and his appetite also. He was sleeping & crying for the most part and his fever was being stabilized by MOTRIN and TYLENOL.


Changed on 5/21/2021

VAERS ID: 422268 Before After
VAERS Form:1
Age:0.82
Sex:Male
Location:Texas
Vaccinated:2011-02-17
Onset:2011-02-18
Submitted:0000-00-00
Entered:2011-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS AC20B172AA / 4 UN / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 915192 / 4 UN / UN

Administered by: Private      Purchased by: Private
Symptoms: Crying, Death, Pyrexia, Somnolence, Decreased appetite, Infantile spitting up

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-02-23
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Ear infection
Preexisting Conditions: Immunology problems undiagnosed
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: He was administered the shot and by the next day started having fevers & spitting up his food. His fever got worse and his appetite also. He was sleeping & crying for the most part and his fever was being stabilized by MOTRIN and TYLENOL.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=422268&WAYBACKHISTORY=ON


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