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This is VAERS ID 25619

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 25619
VAERS Form:
Age:0.5
Sex:Male
Location:New York
Vaccinated:1990-07-17
Onset:1990-07-17
Submitted:0000-00-00
Entered:1990-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 262913 / - - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: CONVULS, FEVER

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? Yes
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: LP- 70- RBC, 0- WBC, 35- protein, 75- glucose, Culture no growth, CBC- WBC 20,300, Het- 33, PHS- normal, blood culture no grwoth, EEG- normal
CDC 'Split Type':

Write-up: 6 hrs p/ 3rd DPT generalized tonic clonic seizure approx. 45 min. assoc. /w fever. Taken to hospital & then to MD for evaluation.


Changed on 12/8/2009

VAERS ID: 25619 Before After
VAERS Form:
Age:0.5
Sex:Male
Location:New York
Vaccinated:1990-07-17
Onset:1990-07-17
Submitted:0000-00-00
Entered:1990-07-31 1990-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL DTP (TRI-IMMUNOL) / LEDERLE LEDERLE LABORATORIES 262913 / - - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion, Pyrexia, CONVULS, FEVER

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? Yes
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: LP- 70- RBC, 0- WBC, 35- protein, 75- glucose, Culture no growth, CBC- WBC 20,300, Het- 33, PHS- normal, blood culture no grwoth, EEG- normal
CDC 'Split Type':

Write-up: 6 hrs p/ 3rd DPT generalized tonic clonic seizure approx. 45 min. assoc. /w fever. Taken to hospital & then to MD for evaluation.


Changed on 5/14/2017

VAERS ID: 25619 Before After
VAERS Form:
Age:0.5
Sex:Male
Location:New York
Vaccinated:1990-07-17
Onset:1990-07-17
Submitted:0000-00-00
Entered:1990-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 262913 / - - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion, Pyrexia

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? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: LP- 70- RBC, 0- WBC, 35- protein, 75- glucose, Culture no growth, CBC- WBC 20,300, Het- 33, PHS- normal, blood culture no grwoth, EEG- normal
CDC 'Split Type':

Write-up: 6 hrs p/ 3rd DPT generalized tonic clonic seizure approx. 45 min. assoc. /w fever. Taken to hospital & then to MD for evaluation.


Changed on 9/14/2017

VAERS ID: 25619 Before After
VAERS Form:(blank) 1
Age:0.5
Sex:Male
Location:New York
Vaccinated:1990-07-17
Onset:1990-07-17
Submitted:0000-00-00
Entered:1990-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 262913 / - UNK - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion, Pyrexia

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? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: LP- 70- RBC, 0- WBC, 35- protein, 75- glucose, Culture no growth, CBC- WBC 20,300, Het- 33, PHS- normal, blood culture no grwoth, EEG- normal
CDC 'Split Type':

Write-up: 6 hrs p/ 3rd DPT generalized tonic clonic seizure approx. 45 min. assoc. /w fever. Taken to hospital & then to MD for evaluation.


Changed on 2/14/2018

VAERS ID: 25619 Before After
VAERS Form:1
Age:0.5
Sex:Male
Location:New York
Vaccinated:1990-07-17
Onset:1990-07-17
Submitted:0000-00-00
Entered:1990-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 262913 / UNK - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion, Pyrexia

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? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: LP- 70- RBC, 0- WBC, 35- protein, 75- glucose, Culture no growth, CBC- WBC 20,300, Het- 33, PHS- normal, blood culture no grwoth, EEG- normal
CDC 'Split Type':

Write-up: 6 hrs p/ 3rd DPT generalized tonic clonic seizure approx. 45 min. assoc. /w fever. Taken to hospital & then to MD for evaluation.


Changed on 6/14/2018

VAERS ID: 25619 Before After
VAERS Form:1
Age:0.5
Sex:Male
Location:New York
Vaccinated:1990-07-17
Onset:1990-07-17
Submitted:0000-00-00
Entered:1990-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 262913 / UNK - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion, Pyrexia

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? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: LP- 70- RBC, 0- WBC, 35- protein, 75- glucose, Culture no growth, CBC- WBC 20,300, Het- 33, PHS- normal, blood culture no grwoth, EEG- normal
CDC 'Split Type':

Write-up: 6 hrs p/ 3rd DPT generalized tonic clonic seizure approx. 45 min. assoc. /w fever. Taken to hospital & then to MD for evaluation.


Changed on 8/14/2018

VAERS ID: 25619 Before After
VAERS Form:1
Age:0.5
Sex:Male
Location:New York
Vaccinated:1990-07-17
Onset:1990-07-17
Submitted:0000-00-00
Entered:1990-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 262913 / UNK - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion, Pyrexia

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? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: LP- 70- RBC, 0- WBC, 35- protein, 75- glucose, Culture no growth, CBC- WBC 20,300, Het- 33, PHS- normal, blood culture no grwoth, EEG- normal
CDC 'Split Type':

Write-up: 6 hrs p/ 3rd DPT generalized tonic clonic seizure approx. 45 min. assoc. /w fever. Taken to hospital & then to MD for evaluation.


Changed on 9/14/2018

VAERS ID: 25619 Before After
VAERS Form:1
Age:0.5
Sex:Male
Location:New York
Vaccinated:1990-07-17
Onset:1990-07-17
Submitted:0000-00-00
Entered:1990-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 262913 / UNK - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion, Pyrexia

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? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: LP- 70- RBC, 0- WBC, 35- protein, 75- glucose, Culture no growth, CBC- WBC 20,300, Het- 33, PHS- normal, blood culture no grwoth, EEG- normal
CDC 'Split Type':

Write-up: 6 hrs p/ 3rd DPT generalized tonic clonic seizure approx. 45 min. assoc. /w fever. Taken to hospital & then to MD for evaluation.


Changed on 10/14/2018

VAERS ID: 25619 Before After
VAERS Form:1
Age:0.5
Sex:Male
Location:New York
Vaccinated:1990-07-17
Onset:1990-07-17
Submitted:0000-00-00
Entered:1990-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 262913 / UNK - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion, Pyrexia

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? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: LP- 70- RBC, 0- WBC, 35- protein, 75- glucose, Culture no growth, CBC- WBC 20,300, Het- 33, PHS- normal, blood culture no grwoth, EEG- normal
CDC 'Split Type':

Write-up: 6 hrs p/ 3rd DPT generalized tonic clonic seizure approx. 45 min. assoc. /w fever. Taken to hospital & then to MD for evaluation.


Changed on 12/24/2020

VAERS ID: 25619 Before After
VAERS Form:1
Age:0.5
Sex:Male
Location:New York
Vaccinated:1990-07-17
Onset:1990-07-17
Submitted:0000-00-00
Entered:1990-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 262913 / UNK - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion, Pyrexia

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? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: LP- 70- RBC, 0- WBC, 35- protein, 75- glucose, Culture no growth, CBC- WBC 20,300, Het- 33, PHS- normal, blood culture no grwoth, EEG- normal
CDC 'Split Type':

Write-up: 6 hrs p/ 3rd DPT generalized tonic clonic seizure approx. 45 min. assoc. /w fever. Taken to hospital & then to MD for evaluation.


Changed on 12/30/2020

VAERS ID: 25619 Before After
VAERS Form:1
Age:0.5
Sex:Male
Location:New York
Vaccinated:1990-07-17
Onset:1990-07-17
Submitted:0000-00-00
Entered:1990-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 262913 / UNK - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion, Pyrexia

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? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: LP- 70- RBC, 0- WBC, 35- protein, 75- glucose, Culture no growth, CBC- WBC 20,300, Het- 33, PHS- normal, blood culture no grwoth, EEG- normal
CDC 'Split Type':

Write-up: 6 hrs p/ 3rd DPT generalized tonic clonic seizure approx. 45 min. assoc. /w fever. Taken to hospital & then to MD for evaluation.

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