National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 25003

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

25003
VAERS Form:
Age:0.8
Gender:Male
Location:Texas
Vaccinated:1990-01-29
Onset:1990-02-04
Submitted:0000-00-00
Entered:1990-07-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 259962 / 3 - / IM
OPV: ORIMUNE / LEDERLE 241950 / 3 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: BRAIN SYND ACUTE, HYPOKINESIA, HYPOTONIA

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Hypotonic, Hyporesponsive episode, Infant died: Reyes text Syndrome. Vaccine given for routine immunizations.


Changed on 12/8/2009

25003 Before After
VAERS Form:
Age:0.8
Gender:Male
Location:Texas
Vaccinated:1990-01-29
Onset:1990-02-04
Submitted:0000-00-00
Entered:1990-07-05 1990-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL DTP (TRI-IMMUNOL) / LEDERLE LEDERLE LABORATORIES 259962 / 3 - / IM
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES 241950 / 3 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Delirium, Hypokinesia, Hypotonia, BRAIN SYND ACUTE, HYPOKINESIA, HYPOTONIA

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Hypotonic, Hyporesponsive episode, Infant died: Reyes text Syndrome. Vaccine given for routine immunizations.


Changed on 5/14/2017

25003 Before After
VAERS Form:
Age:0.8
Gender:Male
Location:Texas
Vaccinated:1990-01-29
Onset:1990-02-04
Submitted:0000-00-00
Entered:1990-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 259962 / 3 - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 241950 / 3 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Delirium, Hypokinesia, Hypotonia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Hypotonic, Hyporesponsive episode, Infant died: Reyes text Syndrome. Vaccine given for routine immunizations.


Changed on 9/14/2017

25003 Before After
VAERS Form:(blank) 1
Age:0.8
Gender:Male
Location:Texas
Vaccinated:1990-01-29
Onset:1990-02-04
Submitted:0000-00-00
Entered:1990-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 259962 / 3 4 - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 241950 / 3 4 - MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Delirium, Hypokinesia, Hypotonia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Hypotonic, Hyporesponsive episode, Infant died: Reyes text Syndrome. Vaccine given for routine immunizations.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=25003&WAYBACKHISTORY=ON


Copyright © 2017 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166