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This is VAERS ID 26484

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 26484
VAERS Form:
Age:1.5
Sex:Female
Location:California
Vaccinated:1990-09-27
Onset:0000-00-00
Submitted:1990-10-30
Entered:1990-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP / CONNAUGHT LABS - / 3 - / IM
HIBV: PROHIBIT / CONNAUGHT LABS - / 0 - / IM
MMR: MMR II / MSD - / 0 - / IM
OPV: ORIMUNE / LEDERLE - / 2 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: AGITATION, CHILLS, FEVER, APNEA, HEART ARREST

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-10-06
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/OPV/HIB/MMR found apneic in crib on 06OCT90.


Changed on 12/8/2009

VAERS ID: 26484 Before After
VAERS Form:
Age:1.5
Sex:Female
Location:California
Vaccinated:1990-09-27
Onset:0000-00-00
Submitted:1990-10-30
Entered:1990-11-12 1990-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP DTP (NO BRAND NAME) / CONNAUGHT LABS CONNAUGHT LABORATORIES - / 3 - / IM
HIBV: PROHIBIT HIB (PROHIBIT) / CONNAUGHT LABS CONNAUGHT LABORATORIES - / 0 - / IM
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. - / 0 - / IM
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES - / 2 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Agitation, Apnoea, Cardiac arrest, Chills, Pain, Pyrexia, Vasodilatation, AGITATION, CHILLS, FEVER, APNEA, HEART ARREST

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-10-06
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/OPV/HIB/MMR found apneic in crib on 06OCT90.


Changed on 5/14/2017

VAERS ID: 26484 Before After
VAERS Form:
Age:1.5
Sex:Female
Location:California
Vaccinated:1990-09-27
Onset:0000-00-00
Submitted:1990-10-30
Entered:1990-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES - / 3 - / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES - / 0 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 0 - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH - / 2 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Agitation, Apnoea, Cardiac arrest, Chills, Pain, Pyrexia, Vasodilatation

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-10-06
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/OPV/HIB/MMR found apneic in crib on 06OCT90.


Changed on 9/14/2017

VAERS ID: 26484 Before After
VAERS Form:(blank) 1
Age:1.5
Sex:Female
Location:California
Vaccinated:1990-09-27
Onset:0000-00-00
Submitted:1990-10-30
Entered:1990-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES - / 3 4 - / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES - / 0 1 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 0 1 - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH - / 2 3 - MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Agitation, Apnoea, Cardiac arrest, Chills, Pain, Pyrexia, Vasodilatation

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-10-06
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/OPV/HIB/MMR found apneic in crib on 06OCT90.


Changed on 2/14/2018

VAERS ID: 26484 Before After
VAERS Form:1
Age:1.5
Sex:Female
Location:California
Vaccinated:1990-09-27
Onset:0000-00-00
Submitted:1990-10-30
Entered:1990-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES - / 4 - / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES - / 1 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 1 - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH - / 3 MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Agitation, Apnoea, Cardiac arrest, Chills, Pain, Pyrexia, Vasodilatation

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-10-06
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/OPV/HIB/MMR found apneic in crib on 06OCT90.


Changed on 6/14/2018

VAERS ID: 26484 Before After
VAERS Form:1
Age:1.5
Sex:Female
Location:California
Vaccinated:1990-09-27
Onset:0000-00-00
Submitted:1990-10-30
Entered:1990-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES - / 4 - / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES - / 1 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 1 - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH - / 3 MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Agitation, Apnoea, Cardiac arrest, Chills, Pain, Pyrexia, Vasodilatation

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-10-06
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/OPV/HIB/MMR found apneic in crib on 06OCT90.


Changed on 8/14/2018

VAERS ID: 26484 Before After
VAERS Form:1
Age:1.5
Sex:Female
Location:California
Vaccinated:1990-09-27
Onset:0000-00-00
Submitted:1990-10-30
Entered:1990-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES - / 4 - / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES - / 1 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 1 - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH - / 3 MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Agitation, Apnoea, Cardiac arrest, Chills, Pain, Pyrexia, Vasodilatation

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-10-06
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/OPV/HIB/MMR found apneic in crib on 06OCT90.


Changed on 9/14/2018

VAERS ID: 26484 Before After
VAERS Form:1
Age:1.5
Sex:Female
Location:California
Vaccinated:1990-09-27
Onset:0000-00-00
Submitted:1990-10-30
Entered:1990-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES - / 4 - / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES - / 1 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 1 - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH - / 3 MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Agitation, Apnoea, Cardiac arrest, Chills, Pain, Pyrexia, Vasodilatation

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-10-06
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/OPV/HIB/MMR found apneic in crib on 06OCT90.


Changed on 10/14/2018

VAERS ID: 26484 Before After
VAERS Form:1
Age:1.5
Sex:Female
Location:California
Vaccinated:1990-09-27
Onset:0000-00-00
Submitted:1990-10-30
Entered:1990-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES - / 4 - / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES - / 1 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 1 - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH - / 3 MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Agitation, Apnoea, Cardiac arrest, Chills, Pain, Pyrexia, Vasodilatation

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-10-06
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/OPV/HIB/MMR found apneic in crib on 06OCT90.

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=26484&WAYBACKHISTORY=ON


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