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This is VAERS ID 26224

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 26224
VAERS Form:
Age:1.3
Sex:Female
Location:Missouri
Vaccinated:1990-07-31
Onset:1990-08-05
Submitted:1990-10-06
Entered:1990-10-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HBPV: HIBIMUNE / LEDERLE - / 0 - / IM
MMR: MMR II / MSD - / 0 - / SC

Administered by: Private      Purchased by: Unknown
Symptoms: SIDS, EDEMA FACE, EDEMA, ALLERG REACT

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-08-11
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: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Hypoglycemic of Newborn; R/O Sepc as newborn
Allergies:
Diagnostic Lab Data: Chest X-Ray Neg; All lab work neg; SGOT = 200; NA 123; EKG neg; ECHO heart neg
CDC 'Split Type':

Write-up: Pt vaccinated with MMR/HIB developed puffy eyes seen in office dx allergy given Benadryl; Seen 8AUG some vomiting, 9AUG admitted more puffiness & edematous See WORM for more details.


Changed on 12/8/2009

VAERS ID: 26224 Before After
VAERS Form:
Age:1.3
Sex:Female
Location:Missouri
Vaccinated:1990-07-31
Onset:1990-08-05
Submitted:1990-10-06
Entered:1990-10-16 1990-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HBPV: HIBIMUNE HIB POLYSACCHARIDE (HIBIMUNE) / LEDERLE LEDERLE LABORATORIES - / 0 - / IM
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. - / 0 - / SC

Administered by: Private      Purchased by: Unknown Private
Symptoms: Face oedema, Hypersensitivity, Oedema, SIDS, Sudden infant death syndrome, EDEMA FACE, EDEMA, ALLERG REACT

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-08-11
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: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Hypoglycemic of Newborn; R/O Sepc as newborn
Allergies:
Diagnostic Lab Data: Chest X-Ray Neg; All lab work neg; SGOT = 200; NA 123; EKG neg; ECHO heart neg
CDC 'Split Type':

Write-up: Pt vaccinated with MMR/HIB developed puffy eyes seen in office dx allergy given Benadryl; Seen 8AUG some vomiting, 9AUG admitted more puffiness & edematous See WORM for more details.


Changed on 5/14/2017

VAERS ID: 26224 Before After
VAERS Form:
Age:1.3
Sex:Female
Location:Missouri
Vaccinated:1990-07-31
Onset:1990-08-05
Submitted:1990-10-06
Entered:1990-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HBPV: HIB POLYSACCHARIDE (HIBIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH - / 0 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 0 - / SC

Administered by: Private      Purchased by: Private
Symptoms: Face oedema, Hypersensitivity, Oedema, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-08-11
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: 2     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: Hypoglycemic of Newborn; R/O Sepc as newborn
Allergies:
Diagnostic Lab Data: Chest X-Ray Neg; All lab work neg; SGOT = 200; NA 123; EKG neg; ECHO heart neg
CDC 'Split Type':

Write-up: Pt vaccinated with MMR/HIB developed puffy eyes seen in office dx allergy given Benadryl; Seen 8AUG some vomiting, 9AUG admitted more puffiness & edematous See WORM for more details.


Changed on 9/14/2017

VAERS ID: 26224 Before After
VAERS Form:(blank) 1
Age:1.3
Sex:Female
Location:Missouri
Vaccinated:1990-07-31
Onset:1990-08-05
Submitted:1990-10-06
Entered:1990-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HBPV: HIB POLYSACCHARIDE (HIBIMUNE) / PFIZER/WYETH - / 0 1 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 0 1 - / SC

Administered by: Private      Purchased by: Private
Symptoms: Face oedema, Hypersensitivity, Oedema, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-08-11
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: 2     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: Hypoglycemic of Newborn; R/O Sepc as newborn
Allergies:
Diagnostic Lab Data: Chest X-Ray Neg; All lab work neg; SGOT = 200; NA 123; EKG neg; ECHO heart neg
CDC 'Split Type':

Write-up: Pt vaccinated with MMR/HIB developed puffy eyes seen in office dx allergy given Benadryl; Seen 8AUG some vomiting, 9AUG admitted more puffiness & edematous See WORM for more details.


Changed on 2/14/2018

VAERS ID: 26224 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Missouri
Vaccinated:1990-07-31
Onset:1990-08-05
Submitted:1990-10-06
Entered:1990-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HBPV: HIB POLYSACCHARIDE (HIBIMUNE) / PFIZER/WYETH - / 1 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 1 - / SC

Administered by: Private      Purchased by: Private
Symptoms: Face oedema, Hypersensitivity, Oedema, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-08-11
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: 2     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: Hypoglycemic of Newborn; R/O Sepc as newborn
Allergies:
Diagnostic Lab Data: Chest X-Ray Neg; All lab work neg; SGOT = 200; NA 123; EKG neg; ECHO heart neg
CDC 'Split Type':

Write-up: Pt vaccinated with MMR/HIB developed puffy eyes seen in office dx allergy given Benadryl; Seen 8AUG some vomiting, 9AUG admitted more puffiness & edematous See WORM for more details.


Changed on 6/14/2018

VAERS ID: 26224 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Missouri
Vaccinated:1990-07-31
Onset:1990-08-05
Submitted:1990-10-06
Entered:1990-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HBPV: HIB POLYSACCHARIDE (HIBIMUNE) / PFIZER/WYETH - / 1 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 1 - / SC

Administered by: Private      Purchased by: Private
Symptoms: Face oedema, Hypersensitivity, Oedema, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-08-11
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: 2     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: Hypoglycemic of Newborn; R/O Sepc as newborn
Allergies:
Diagnostic Lab Data: Chest X-Ray Neg; All lab work neg; SGOT = 200; NA 123; EKG neg; ECHO heart neg
CDC 'Split Type':

Write-up: Pt vaccinated with MMR/HIB developed puffy eyes seen in office dx allergy given Benadryl; Seen 8AUG some vomiting, 9AUG admitted more puffiness & edematous See WORM for more details.


Changed on 8/14/2018

VAERS ID: 26224 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Missouri
Vaccinated:1990-07-31
Onset:1990-08-05
Submitted:1990-10-06
Entered:1990-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HBPV: HIB POLYSACCHARIDE (HIBIMUNE) / PFIZER/WYETH - / 1 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 1 - / SC

Administered by: Private      Purchased by: Private
Symptoms: Face oedema, Hypersensitivity, Oedema, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-08-11
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: 2     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: Hypoglycemic of Newborn; R/O Sepc as newborn
Allergies:
Diagnostic Lab Data: Chest X-Ray Neg; All lab work neg; SGOT = 200; NA 123; EKG neg; ECHO heart neg
CDC 'Split Type':

Write-up: Pt vaccinated with MMR/HIB developed puffy eyes seen in office dx allergy given Benadryl; Seen 8AUG some vomiting, 9AUG admitted more puffiness & edematous See WORM for more details.


Changed on 9/14/2018

VAERS ID: 26224 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Missouri
Vaccinated:1990-07-31
Onset:1990-08-05
Submitted:1990-10-06
Entered:1990-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HBPV: HIB POLYSACCHARIDE (HIBIMUNE) / PFIZER/WYETH - / 1 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 1 - / SC

Administered by: Private      Purchased by: Private
Symptoms: Face oedema, Hypersensitivity, Oedema, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-08-11
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: 2     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: Hypoglycemic of Newborn; R/O Sepc as newborn
Allergies:
Diagnostic Lab Data: Chest X-Ray Neg; All lab work neg; SGOT = 200; NA 123; EKG neg; ECHO heart neg
CDC 'Split Type':

Write-up: Pt vaccinated with MMR/HIB developed puffy eyes seen in office dx allergy given Benadryl; Seen 8AUG some vomiting, 9AUG admitted more puffiness & edematous See WORM for more details.


Changed on 10/14/2018

VAERS ID: 26224 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Missouri
Vaccinated:1990-07-31
Onset:1990-08-05
Submitted:1990-10-06
Entered:1990-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HBPV: HIB POLYSACCHARIDE (HIBIMUNE) / PFIZER/WYETH - / 1 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 1 - / SC

Administered by: Private      Purchased by: Private
Symptoms: Face oedema, Hypersensitivity, Oedema, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-08-11
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: 2     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: Hypoglycemic of Newborn; R/O Sepc as newborn
Allergies:
Diagnostic Lab Data: Chest X-Ray Neg; All lab work neg; SGOT = 200; NA 123; EKG neg; ECHO heart neg
CDC 'Split Type':

Write-up: Pt vaccinated with MMR/HIB developed puffy eyes seen in office dx allergy given Benadryl; Seen 8AUG some vomiting, 9AUG admitted more puffiness & edematous See WORM for more details.

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