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This is VAERS ID 25174

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 25174
VAERS Form:
Age:0.9
Sex:Female
Location:Indiana
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:1990-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 202634 / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: INFECT, NO DRUG EFFECT

Life Threatening? No
Birth Defect? No
Died? No
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: PT WITH POS DIRECT FLUORESCENT ANTIBODY& HAD RECEIVED 3 DTP''S.HOSP AS A PRECAUTION. PT ATTENDS DAYCARE WHERE INDEX CASE HAD PERTUSSIS.(INDEX NEVER RECEIVED DTP); PROBABLY 4-5 MORE CASES OF PERTUSSIS AT CENTER.


Changed on 12/30/2006

VAERS ID: 25174 Before After
VAERS Form:
Age:0.9
Sex:Female
Location:Indiana
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:1990-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 202634 / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: INFECT, NO DRUG EFFECT

Life Threatening? No
Birth Defect? No
Died? No
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: PT WITH POS DIRECT FLUORESCENT ANTIBODY& HAD RECEIVED 3 DTP''S.HOSP DTP''''S.HOSP AS A PRECAUTION. PT ATTENDS DAYCARE WHERE INDEX CASE HAD PERTUSSIS.(INDEX NEVER RECEIVED DTP); PROBABLY 4-5 MORE CASES OF PERTUSSIS AT CENTER.


Changed on 12/8/2009

VAERS ID: 25174 Before After
VAERS Form:
Age:0.9
Sex:Female
Location:Indiana
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:1990-07-17 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL DTP (TRI-IMMUNOL) / LEDERLE LEDERLE LABORATORIES 202634 / - - / -

Administered by: Private      Purchased by: Unknown Private
Symptoms: Drug ineffective, Infection, INFECT, NO DRUG EFFECT

Life Threatening? No
Birth Defect? No
Died? No
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) 8902565.01

Write-up: PT WITH POS DIRECT FLUORESCENT ANTIBODY& HAD RECEIVED 3 DTP''''S.HOSP DTP''S.HOSP AS A PRECAUTION. PT ATTENDS DAYCARE WHERE INDEX CASE HAD PERTUSSIS.(INDEX NEVER RECEIVED DTP); PROBABLY 4-5 MORE CASES OF PERTUSSIS AT CENTER.


Changed on 5/14/2017

VAERS ID: 25174 Before After
VAERS Form:
Age:0.9
Sex:Female
Location:Indiana
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 202634 / - - / -

Administered by: Private      Purchased by: Private
Symptoms: Drug ineffective, Infection

Life Threatening? No
Birth Defect? No
Died? No
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 8902565.01

Write-up: PT WITH POS DIRECT FLUORESCENT ANTIBODY& HAD RECEIVED 3 DTP''S.HOSP AS A PRECAUTION. PT ATTENDS DAYCARE WHERE INDEX CASE HAD PERTUSSIS.(INDEX NEVER RECEIVED DTP); PROBABLY 4-5 MORE CASES OF PERTUSSIS AT CENTER.


Changed on 9/14/2017

VAERS ID: 25174 Before After
VAERS Form:(blank) 1
Age:0.9
Sex:Female
Location:Indiana
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 202634 / - UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Drug ineffective, Infection

Life Threatening? No
Birth Defect? No
Died? No
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 8902565.01

Write-up: PT WITH POS DIRECT FLUORESCENT ANTIBODY& HAD RECEIVED 3 DTP''S.HOSP AS A PRECAUTION. PT ATTENDS DAYCARE WHERE INDEX CASE HAD PERTUSSIS.(INDEX NEVER RECEIVED DTP); PROBABLY 4-5 MORE CASES OF PERTUSSIS AT CENTER.


Changed on 2/14/2018

VAERS ID: 25174 Before After
VAERS Form:1
Age:0.9
Sex:Female
Location:Indiana
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 202634 / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Drug ineffective, Infection

Life Threatening? No
Birth Defect? No
Died? No
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 8902565.01

Write-up: PT WITH POS DIRECT FLUORESCENT ANTIBODY& HAD RECEIVED 3 DTP''S.HOSP AS A PRECAUTION. PT ATTENDS DAYCARE WHERE INDEX CASE HAD PERTUSSIS.(INDEX NEVER RECEIVED DTP); PROBABLY 4-5 MORE CASES OF PERTUSSIS AT CENTER.


Changed on 6/14/2018

VAERS ID: 25174 Before After
VAERS Form:1
Age:0.9
Sex:Female
Location:Indiana
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 202634 / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Drug ineffective, Infection

Life Threatening? No
Birth Defect? No
Died? No
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 8902565.01

Write-up: PT WITH POS DIRECT FLUORESCENT ANTIBODY& HAD RECEIVED 3 DTP''S.HOSP AS A PRECAUTION. PT ATTENDS DAYCARE WHERE INDEX CASE HAD PERTUSSIS.(INDEX NEVER RECEIVED DTP); PROBABLY 4-5 MORE CASES OF PERTUSSIS AT CENTER.


Changed on 8/14/2018

VAERS ID: 25174 Before After
VAERS Form:1
Age:0.9
Sex:Female
Location:Indiana
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 202634 / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Drug ineffective, Infection

Life Threatening? No
Birth Defect? No
Died? No
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 8902565.01

Write-up: PT WITH POS DIRECT FLUORESCENT ANTIBODY& HAD RECEIVED 3 DTP''S.HOSP AS A PRECAUTION. PT ATTENDS DAYCARE WHERE INDEX CASE HAD PERTUSSIS.(INDEX NEVER RECEIVED DTP); PROBABLY 4-5 MORE CASES OF PERTUSSIS AT CENTER.


Changed on 9/14/2018

VAERS ID: 25174 Before After
VAERS Form:1
Age:0.9
Sex:Female
Location:Indiana
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 202634 / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Drug ineffective, Infection

Life Threatening? No
Birth Defect? No
Died? No
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 8902565.01

Write-up: PT WITH POS DIRECT FLUORESCENT ANTIBODY& HAD RECEIVED 3 DTP''S.HOSP AS A PRECAUTION. PT ATTENDS DAYCARE WHERE INDEX CASE HAD PERTUSSIS.(INDEX NEVER RECEIVED DTP); PROBABLY 4-5 MORE CASES OF PERTUSSIS AT CENTER.


Changed on 10/14/2018

VAERS ID: 25174 Before After
VAERS Form:1
Age:0.9
Sex:Female
Location:Indiana
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 202634 / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Drug ineffective, Infection

Life Threatening? No
Birth Defect? No
Died? No
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 8902565.01

Write-up: PT WITH POS DIRECT FLUORESCENT ANTIBODY& HAD RECEIVED 3 DTP''S.HOSP AS A PRECAUTION. PT ATTENDS DAYCARE WHERE INDEX CASE HAD PERTUSSIS.(INDEX NEVER RECEIVED DTP); PROBABLY 4-5 MORE CASES OF PERTUSSIS AT CENTER.


Changed on 12/24/2020

VAERS ID: 25174 Before After
VAERS Form:1
Age:0.9
Sex:Female
Location:Indiana
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 202634 / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Drug ineffective, Infection

Life Threatening? No
Birth Defect? No
Died? No
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 8902565.01

Write-up: PT WITH POS DIRECT FLUORESCENT ANTIBODY& HAD RECEIVED 3 DTP''S.HOSP AS A PRECAUTION. PT ATTENDS DAYCARE WHERE INDEX CASE HAD PERTUSSIS.(INDEX NEVER RECEIVED DTP); PROBABLY 4-5 MORE CASES OF PERTUSSIS AT CENTER.


Changed on 12/30/2020

VAERS ID: 25174 Before After
VAERS Form:1
Age:0.9
Sex:Female
Location:Indiana
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 202634 / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Drug ineffective, Infection

Life Threatening? No
Birth Defect? No
Died? No
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 8902565.01

Write-up: PT WITH POS DIRECT FLUORESCENT ANTIBODY& HAD RECEIVED 3 DTP''S.HOSP AS A PRECAUTION. PT ATTENDS DAYCARE WHERE INDEX CASE HAD PERTUSSIS.(INDEX NEVER RECEIVED DTP); PROBABLY 4-5 MORE CASES OF PERTUSSIS AT CENTER.

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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=25174&WAYBACKHISTORY=ON


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