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This is VAERS ID 25994

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 25994
VAERS Form:
Age:1.3
Sex:Male
Location:Wyoming
Vaccinated:1989-12-05
Onset:1989-12-29
Submitted:0000-00-00
Entered:1990-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 256957 / 3 L / -
MMR: MMR II / MSD 2068P / 0 L / -
OPV: ORIMUNE / LEDERLE 298B1 / 2 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: EDEMA LUNG, EDEMA BRAIN, ASPHYXIA, HEM LUNG, IMMUNE SYSTEM DIS

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: Pedizole, Tassi Organdin
Current Illness: Otitis, Bronchitis
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Autopsy was contradictory /w no conclusions & many signs of Pertussis reactions.
CDC 'Split Type':

Write-up: Casey was given DPT/MMR/OPV while still on anitbiotic Pedizole and tassii organdin for otitis & bronchitis. He appeared happy & well until he died in his sleep. Shots were given on 5DEC89.


Changed on 12/8/2009

VAERS ID: 25994 Before After
VAERS Form:
Age:1.3
Sex:Male
Location:Wyoming
Vaccinated:1989-12-05
Onset:1989-12-29
Submitted:0000-00-00
Entered:1990-09-25 1990-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL DTP (TRI-IMMUNOL) / LEDERLE LEDERLE LABORATORIES 256957 / 3 L / -
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 2068P / 0 L / -
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES 298B1 / 2 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asphyxia, Immune system disorder, Infection, Necrosis, Pulmonary haemorrhage, Pulmonary oedema, Splenomegaly, Brain oedema, EDEMA LUNG, EDEMA BRAIN, ASPHYXIA, HEM LUNG, IMMUNE SYSTEM DIS

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: Pedizole, Tassi Organdin
Current Illness: Otitis, Bronchitis
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Autopsy was contradictory /w no conclusions & many signs of Pertussis reactions.
CDC 'Split Type':

Write-up: Casey was given DPT/MMR/OPV while still on anitbiotic Pedizole and tassii organdin for otitis & bronchitis. He appeared happy & well until he died in his sleep. Shots were given on 5DEC89.


Changed on 5/14/2017

VAERS ID: 25994 Before After
VAERS Form:
Age:1.3
Sex:Male
Location:Wyoming
Vaccinated:1989-12-05
Onset:1989-12-29
Submitted:0000-00-00
Entered:1990-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 256957 / 3 L - / - L
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 2068P / 0 L - / - L
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 298B1 / 2 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asphyxia, Immune system disorder, Infection, Necrosis, Pulmonary haemorrhage, Pulmonary oedema, Splenomegaly, Brain oedema

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: Pedizole, Tassi Organdin
Current Illness: Otitis, Bronchitis
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Autopsy was contradictory /w no conclusions & many signs of Pertussis reactions.
CDC 'Split Type':

Write-up: Casey was given DPT/MMR/OPV while still on anitbiotic Pedizole and tassii organdin for otitis & bronchitis. He appeared happy & well until he died in his sleep. Shots were given on 5DEC89.


Changed on 9/14/2017

VAERS ID: 25994 Before After
VAERS Form:(blank) 1
Age:1.3
Sex:Male
Location:Wyoming
Vaccinated:1989-12-05
Onset:1989-12-29
Submitted:0000-00-00
Entered:1990-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 256957 / 3 4 - / L
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 2068P / 0 1 - / L
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 298B1 / 2 3 - MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asphyxia, Immune system disorder, Infection, Necrosis, Pulmonary haemorrhage, Pulmonary oedema, Splenomegaly, Brain oedema

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: Pedizole, Tassi Organdin
Current Illness: Otitis, Bronchitis
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Autopsy was contradictory /w no conclusions & many signs of Pertussis reactions.
CDC 'Split Type':

Write-up: Casey was given DPT/MMR/OPV while still on anitbiotic Pedizole and tassii organdin for otitis & bronchitis. He appeared happy & well until he died in his sleep. Shots were given on 5DEC89.


Changed on 2/14/2018

VAERS ID: 25994 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:Wyoming
Vaccinated:1989-12-05
Onset:1989-12-29
Submitted:0000-00-00
Entered:1990-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 256957 / 4 - / L
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 2068P / 1 - / L
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 298B1 / 3 MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asphyxia, Immune system disorder, Infection, Necrosis, Pulmonary haemorrhage, Pulmonary oedema, Splenomegaly, Brain oedema

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: Pedizole, Tassi Organdin
Current Illness: Otitis, Bronchitis
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Autopsy was contradictory /w no conclusions & many signs of Pertussis reactions.
CDC 'Split Type':

Write-up: Casey was given DPT/MMR/OPV while still on anitbiotic Pedizole and tassii organdin for otitis & bronchitis. He appeared happy & well until he died in his sleep. Shots were given on 5DEC89.


Changed on 6/14/2018

VAERS ID: 25994 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:Wyoming
Vaccinated:1989-12-05
Onset:1989-12-29
Submitted:0000-00-00
Entered:1990-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 256957 / 4 - / L
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 2068P / 1 - / L
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 298B1 / 3 MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asphyxia, Immune system disorder, Infection, Necrosis, Pulmonary haemorrhage, Pulmonary oedema, Splenomegaly, Brain oedema

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: Pedizole, Tassi Organdin
Current Illness: Otitis, Bronchitis
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Autopsy was contradictory /w no conclusions & many signs of Pertussis reactions.
CDC 'Split Type':

Write-up: Casey was given DPT/MMR/OPV while still on anitbiotic Pedizole and tassii organdin for otitis & bronchitis. He appeared happy & well until he died in his sleep. Shots were given on 5DEC89.


Changed on 8/14/2018

VAERS ID: 25994 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:Wyoming
Vaccinated:1989-12-05
Onset:1989-12-29
Submitted:0000-00-00
Entered:1990-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 256957 / 4 - / L
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 2068P / 1 - / L
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 298B1 / 3 MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asphyxia, Immune system disorder, Infection, Necrosis, Pulmonary haemorrhage, Pulmonary oedema, Splenomegaly, Brain oedema

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: Pedizole, Tassi Organdin
Current Illness: Otitis, Bronchitis
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Autopsy was contradictory /w no conclusions & many signs of Pertussis reactions.
CDC 'Split Type':

Write-up: Casey was given DPT/MMR/OPV while still on anitbiotic Pedizole and tassii organdin for otitis & bronchitis. He appeared happy & well until he died in his sleep. Shots were given on 5DEC89.


Changed on 9/14/2018

VAERS ID: 25994 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:Wyoming
Vaccinated:1989-12-05
Onset:1989-12-29
Submitted:0000-00-00
Entered:1990-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 256957 / 4 - / L
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 2068P / 1 - / L
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 298B1 / 3 MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asphyxia, Immune system disorder, Infection, Necrosis, Pulmonary haemorrhage, Pulmonary oedema, Splenomegaly, Brain oedema

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: Pedizole, Tassi Organdin
Current Illness: Otitis, Bronchitis
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Autopsy was contradictory /w no conclusions & many signs of Pertussis reactions.
CDC 'Split Type':

Write-up: Casey was given DPT/MMR/OPV while still on anitbiotic Pedizole and tassii organdin for otitis & bronchitis. He appeared happy & well until he died in his sleep. Shots were given on 5DEC89.


Changed on 10/14/2018

VAERS ID: 25994 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:Wyoming
Vaccinated:1989-12-05
Onset:1989-12-29
Submitted:0000-00-00
Entered:1990-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 256957 / 4 - / L
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 2068P / 1 - / L
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 298B1 / 3 MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asphyxia, Immune system disorder, Infection, Necrosis, Pulmonary haemorrhage, Pulmonary oedema, Splenomegaly, Brain oedema

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: Pedizole, Tassi Organdin
Current Illness: Otitis, Bronchitis
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Autopsy was contradictory /w no conclusions & many signs of Pertussis reactions.
CDC 'Split Type':

Write-up: Casey was given DPT/MMR/OPV while still on anitbiotic Pedizole and tassii organdin for otitis & bronchitis. He appeared happy & well until he died in his sleep. Shots were given on 5DEC89.

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=25994&WAYBACKHISTORY=ON


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