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This is VAERS ID 25648

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 25648
VAERS Form:
Age:1.5
Sex:Female
Location:Texas
Vaccinated:1989-11-17
Onset:1989-11-17
Submitted:0000-00-00
Entered:1990-08-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP / CONNAUGHT LABS - / - - / -
HIBV: PROHIBIT / CONNAUGHT LABS - / - - / -
OPV: ORIMUNE / LEDERLE - / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: CONVULS, FEVER, STUPOR, PALLOR, VISION ABNORM

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: no prior history on rxn''s
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt received ORIMUNE, DTP, PROHIBIT and was not focusing, in a daze, pale but not rigidly seizing. Seen in ER was febrile. Hospitalized for observation & placed on monitor. MD impression is seizure.


Changed on 12/8/2009

VAERS ID: 25648 Before After
VAERS Form:
Age:1.5
Sex:Female
Location:Texas
Vaccinated:1989-11-17
Onset:1989-11-17
Submitted:0000-00-00
Entered:1990-08-08 1990-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP DTP (NO BRAND NAME) / CONNAUGHT LABS CONNAUGHT LABORATORIES - / - - / -
HIBV: PROHIBIT HIB (PROHIBIT) / CONNAUGHT LABS CONNAUGHT LABORATORIES - / - - / -
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES - / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion, Pallor, Pyrexia, Stupor, Visual disturbance, CONVULS, FEVER, STUPOR, PALLOR, VISION ABNORM

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: no prior history on rxn''s
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) 8902745.01

Write-up: Pt received ORIMUNE, DTP, PROHIBIT and was not focusing, in a daze, pale but not rigidly seizing. Seen in ER was febrile. Hospitalized for observation & placed on monitor. MD impression is seizure.


Changed on 5/14/2017

VAERS ID: 25648 Before After
VAERS Form:
Age:1.5
Sex:Female
Location:Texas
Vaccinated:1989-11-17
Onset:1989-11-17
Submitted:0000-00-00
Entered:1990-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES - / - - / -
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES - / - - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH - / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion, Pallor, Pyrexia, Stupor, Visual disturbance

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: no prior history on rxn''s
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 8902745.01

Write-up: Pt received ORIMUNE, DTP, PROHIBIT and was not focusing, in a daze, pale but not rigidly seizing. Seen in ER was febrile. Hospitalized for observation & placed on monitor. MD impression is seizure.


Changed on 9/14/2017

VAERS ID: 25648 Before After
VAERS Form:(blank) 1
Age:1.5
Sex:Female
Location:Texas
Vaccinated:1989-11-17
Onset:1989-11-17
Submitted:0000-00-00
Entered:1990-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES - / - UNK - / -
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES - / - UNK - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH - / - UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion, Pallor, Pyrexia, Stupor, Visual disturbance

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: no prior history on rxn''s
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 8902745.01

Write-up: Pt received ORIMUNE, DTP, PROHIBIT and was not focusing, in a daze, pale but not rigidly seizing. Seen in ER was febrile. Hospitalized for observation & placed on monitor. MD impression is seizure.


Changed on 2/14/2018

VAERS ID: 25648 Before After
VAERS Form:1
Age:1.5
Sex:Female
Location:Texas
Vaccinated:1989-11-17
Onset:1989-11-17
Submitted:0000-00-00
Entered:1990-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES - / UNK - / -
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES - / UNK - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH - / UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion, Pallor, Pyrexia, Stupor, Visual disturbance

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: no prior history on rxn''s
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 8902745.01

Write-up: Pt received ORIMUNE, DTP, PROHIBIT and was not focusing, in a daze, pale but not rigidly seizing. Seen in ER was febrile. Hospitalized for observation & placed on monitor. MD impression is seizure.


Changed on 6/14/2018

VAERS ID: 25648 Before After
VAERS Form:1
Age:1.5
Sex:Female
Location:Texas
Vaccinated:1989-11-17
Onset:1989-11-17
Submitted:0000-00-00
Entered:1990-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES - / UNK - / -
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES - / UNK - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH - / UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion, Pallor, Pyrexia, Stupor, Visual disturbance

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: no prior history on rxn''s
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 8902745.01

Write-up: Pt received ORIMUNE, DTP, PROHIBIT and was not focusing, in a daze, pale but not rigidly seizing. Seen in ER was febrile. Hospitalized for observation & placed on monitor. MD impression is seizure.


Changed on 8/14/2018

VAERS ID: 25648 Before After
VAERS Form:1
Age:1.5
Sex:Female
Location:Texas
Vaccinated:1989-11-17
Onset:1989-11-17
Submitted:0000-00-00
Entered:1990-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES - / UNK - / -
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES - / UNK - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH - / UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion, Pallor, Pyrexia, Stupor, Visual disturbance

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: no prior history on rxn''s
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 8902745.01

Write-up: Pt received ORIMUNE, DTP, PROHIBIT and was not focusing, in a daze, pale but not rigidly seizing. Seen in ER was febrile. Hospitalized for observation & placed on monitor. MD impression is seizure.


Changed on 9/14/2018

VAERS ID: 25648 Before After
VAERS Form:1
Age:1.5
Sex:Female
Location:Texas
Vaccinated:1989-11-17
Onset:1989-11-17
Submitted:0000-00-00
Entered:1990-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES - / UNK - / -
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES - / UNK - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH - / UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion, Pallor, Pyrexia, Stupor, Visual disturbance

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: no prior history on rxn''s
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 8902745.01

Write-up: Pt received ORIMUNE, DTP, PROHIBIT and was not focusing, in a daze, pale but not rigidly seizing. Seen in ER was febrile. Hospitalized for observation & placed on monitor. MD impression is seizure.


Changed on 10/14/2018

VAERS ID: 25648 Before After
VAERS Form:1
Age:1.5
Sex:Female
Location:Texas
Vaccinated:1989-11-17
Onset:1989-11-17
Submitted:0000-00-00
Entered:1990-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES - / UNK - / -
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES - / UNK - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH - / UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion, Pallor, Pyrexia, Stupor, Visual disturbance

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: no prior history on rxn''s
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 8902745.01

Write-up: Pt received ORIMUNE, DTP, PROHIBIT and was not focusing, in a daze, pale but not rigidly seizing. Seen in ER was febrile. Hospitalized for observation & placed on monitor. MD impression is seizure.


Changed on 12/24/2020

VAERS ID: 25648 Before After
VAERS Form:1
Age:1.5
Sex:Female
Location:Texas
Vaccinated:1989-11-17
Onset:1989-11-17
Submitted:0000-00-00
Entered:1990-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES - / UNK - / -
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES - / UNK - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH - / UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion, Pallor, Pyrexia, Stupor, Visual disturbance

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: no prior history on rxn''s
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 8902745.01

Write-up: Pt received ORIMUNE, DTP, PROHIBIT and was not focusing, in a daze, pale but not rigidly seizing. Seen in ER was febrile. Hospitalized for observation & placed on monitor. MD impression is seizure.


Changed on 12/30/2020

VAERS ID: 25648 Before After
VAERS Form:1
Age:1.5
Sex:Female
Location:Texas
Vaccinated:1989-11-17
Onset:1989-11-17
Submitted:0000-00-00
Entered:1990-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES - / UNK - / -
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES - / UNK - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH - / UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion, Pallor, Pyrexia, Stupor, Visual disturbance

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: no prior history on rxn''s
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 8902745.01

Write-up: Pt received ORIMUNE, DTP, PROHIBIT and was not focusing, in a daze, pale but not rigidly seizing. Seen in ER was febrile. Hospitalized for observation & placed on monitor. MD impression is seizure.

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