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This is VAERS ID 26790

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History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 26790
VAERS Form:
Age:0.3
Sex:Male
Location:Maryland
Vaccinated:1990-04-11
Onset:1990-04-11
Submitted:0000-00-00
Entered:1990-11-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE - / - - / -
IPV: POLIOVAX / CONNAUGHT LTD - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: CONVULS

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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: No personal or family hx of convulsions.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with DTP and IPV and developed two convulsions. Unspecified focal neurologic signs & could not cry. LP normal.


Changed on 12/8/2009

VAERS ID: 26790 Before After
VAERS Form:
Age:0.3
Sex:Male
Location:Maryland
Vaccinated:1990-04-11
Onset:1990-04-11
Submitted:0000-00-00
Entered:1990-11-29 1990-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL DTP (TRI-IMMUNOL) / LEDERLE LEDERLE LABORATORIES - / - - / -
IPV: POLIOVAX POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD CONNAUGHT LTD. - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Convulsion, CONVULS

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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: No personal or family hx of convulsions.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) 900107201

Write-up: Pt vaccinated with DTP and IPV and developed two convulsions. Unspecified focal neurologic signs & could not cry. LP normal.


Changed on 5/14/2017

VAERS ID: 26790 Before After
VAERS Form:
Age:0.3
Sex:Male
Location:Maryland
Vaccinated:1990-04-11
Onset:1990-04-11
Submitted:0000-00-00
Entered:1990-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES - / - - / -
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Convulsion

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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: No personal or family hx of convulsions.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 900107201

Write-up: Pt vaccinated with DTP and IPV and developed two convulsions. Unspecified focal neurologic signs & could not cry. LP normal.


Changed on 9/14/2017

VAERS ID: 26790 Before After
VAERS Form:(blank) 1
Age:0.3
Sex:Male
Location:Maryland
Vaccinated:1990-04-11
Onset:1990-04-11
Submitted:0000-00-00
Entered:1990-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES - / - UNK - / -
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. - / - UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Convulsion

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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: No personal or family hx of convulsions.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 900107201

Write-up: Pt vaccinated with DTP and IPV and developed two convulsions. Unspecified focal neurologic signs & could not cry. LP normal.


Changed on 2/14/2018

VAERS ID: 26790 Before After
VAERS Form:1
Age:0.3
Sex:Male
Location:Maryland
Vaccinated:1990-04-11
Onset:1990-04-11
Submitted:0000-00-00
Entered:1990-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES - / UNK - / -
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Convulsion

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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: No personal or family hx of convulsions.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 900107201

Write-up: Pt vaccinated with DTP and IPV and developed two convulsions. Unspecified focal neurologic signs & could not cry. LP normal.


Changed on 6/14/2018

VAERS ID: 26790 Before After
VAERS Form:1
Age:0.3
Sex:Male
Location:Maryland
Vaccinated:1990-04-11
Onset:1990-04-11
Submitted:0000-00-00
Entered:1990-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES - / UNK - / -
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Convulsion

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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: No personal or family hx of convulsions.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 900107201

Write-up: Pt vaccinated with DTP and IPV and developed two convulsions. Unspecified focal neurologic signs & could not cry. LP normal.


Changed on 8/14/2018

VAERS ID: 26790 Before After
VAERS Form:1
Age:0.3
Sex:Male
Location:Maryland
Vaccinated:1990-04-11
Onset:1990-04-11
Submitted:0000-00-00
Entered:1990-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES - / UNK - / -
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Convulsion

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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: No personal or family hx of convulsions.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 900107201

Write-up: Pt vaccinated with DTP and IPV and developed two convulsions. Unspecified focal neurologic signs & could not cry. LP normal.


Changed on 9/14/2018

VAERS ID: 26790 Before After
VAERS Form:1
Age:0.3
Sex:Male
Location:Maryland
Vaccinated:1990-04-11
Onset:1990-04-11
Submitted:0000-00-00
Entered:1990-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES - / UNK - / -
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Convulsion

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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: No personal or family hx of convulsions.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 900107201

Write-up: Pt vaccinated with DTP and IPV and developed two convulsions. Unspecified focal neurologic signs & could not cry. LP normal.


Changed on 10/14/2018

VAERS ID: 26790 Before After
VAERS Form:1
Age:0.3
Sex:Male
Location:Maryland
Vaccinated:1990-04-11
Onset:1990-04-11
Submitted:0000-00-00
Entered:1990-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES - / UNK - / -
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Convulsion

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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: No personal or family hx of convulsions.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 900107201

Write-up: Pt vaccinated with DTP and IPV and developed two convulsions. Unspecified focal neurologic signs & could not cry. LP normal.


Changed on 12/24/2020

VAERS ID: 26790 Before After
VAERS Form:1
Age:0.3
Sex:Male
Location:Maryland
Vaccinated:1990-04-11
Onset:1990-04-11
Submitted:0000-00-00
Entered:1990-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES - / UNK - / -
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Convulsion

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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: No personal or family hx of convulsions.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 900107201

Write-up: Pt vaccinated with DTP and IPV and developed two convulsions. Unspecified focal neurologic signs & could not cry. LP normal.


Changed on 12/30/2020

VAERS ID: 26790 Before After
VAERS Form:1
Age:0.3
Sex:Male
Location:Maryland
Vaccinated:1990-04-11
Onset:1990-04-11
Submitted:0000-00-00
Entered:1990-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES - / UNK - / -
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Convulsion

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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: No personal or family hx of convulsions.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 900107201

Write-up: Pt vaccinated with DTP and IPV and developed two convulsions. Unspecified focal neurologic signs & could not cry. LP normal.


Changed on 5/7/2021

VAERS ID: 26790 Before After
VAERS Form:1
Age:0.3
Sex:Male
Location:Maryland
Vaccinated:1990-04-11
Onset:1990-04-11
Submitted:0000-00-00
Entered:1990-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES - / UNK - / -
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Convulsion

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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: No personal or family hx of convulsions.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 900107201

Write-up: Pt vaccinated with DTP and IPV and developed two convulsions. Unspecified focal neurologic signs & could not cry. LP normal.


Changed on 5/14/2021

VAERS ID: 26790 Before After
VAERS Form:1
Age:0.3
Sex:Male
Location:Maryland
Vaccinated:1990-04-11
Onset:1990-04-11
Submitted:0000-00-00
Entered:1990-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES - / UNK - / -
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Convulsion

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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: No personal or family hx of convulsions.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 900107201

Write-up: Pt vaccinated with DTP and IPV and developed two convulsions. Unspecified focal neurologic signs & could not cry. LP normal.

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=26790&WAYBACKHISTORY=ON


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