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This is VAERS ID 26836

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 26836
VAERS Form:
Age:0.2
Sex:Male
Location:Alaska
Vaccinated:1990-10-24
Onset:1990-10-24
Submitted:1990-11-06
Entered:1990-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 283913 / 0 RL / IM
HEP: RECOMBIVAX HB / MSD 1880R / 1 LL / IM
OPV: ORIMUNE / LEDERLE 277941 / 0 - / PO

Administered by: Public      Purchased by: Unknown
Symptoms: CONVULS, FEVER, TREMOR

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Allergies:
Diagnostic Lab Data: Lumbar puncture - results normal
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/OPV/Recomb developed fever of 103, convulsions, fine tremor.


Changed on 12/8/2009

VAERS ID: 26836 Before After
VAERS Form:
Age:0.2
Sex:Male
Location:Alaska
Vaccinated:1990-10-24
Onset:1990-10-24
Submitted:1990-11-06
Entered:1990-12-04 1990-11-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL DTP (TRI-IMMUNOL) / LEDERLE LEDERLE LABORATORIES 283913 / 0 RL / IM
HEP: RECOMBIVAX HB HEP B (RECOMBIVAX HB) / MSD MERCK & CO. INC. 1880R / 1 LL / IM
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES 277941 / 0 - / PO

Administered by: Public      Purchased by: Unknown
Symptoms: Convulsion, Pyrexia, Tremor, CONVULS, FEVER, TREMOR

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Allergies:
Diagnostic Lab Data: Lumbar puncture - results normal
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/OPV/Recomb developed fever of 103, convulsions, fine tremor.


Changed on 5/14/2017

VAERS ID: 26836 Before After
VAERS Form:
Age:0.2
Sex:Male
Location:Alaska
Vaccinated:1990-10-24
Onset:1990-10-24
Submitted:1990-11-06
Entered:1990-11-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 283913 / 0 RL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1880R / 1 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 277941 / 0 - / PO

Administered by: Public      Purchased by: Unknown
Symptoms: Convulsion, Pyrexia, Tremor

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Allergies:
Diagnostic Lab Data: Lumbar puncture - results normal
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/OPV/Recomb developed fever of 103, convulsions, fine tremor.


Changed on 9/14/2017

VAERS ID: 26836 Before After
VAERS Form:(blank) 1
Age:0.2
Sex:Male
Location:Alaska
Vaccinated:1990-10-24
Onset:1990-10-24
Submitted:1990-11-06
Entered:1990-11-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 283913 / 0 1 RL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1880R / 1 2 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 277941 / 0 1 - MO / PO

Administered by: Public      Purchased by: Unknown
Symptoms: Convulsion, Pyrexia, Tremor

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Allergies:
Diagnostic Lab Data: Lumbar puncture - results normal
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/OPV/Recomb developed fever of 103, convulsions, fine tremor.


Changed on 2/14/2018

VAERS ID: 26836 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Alaska
Vaccinated:1990-10-24
Onset:1990-10-24
Submitted:1990-11-06
Entered:1990-11-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 283913 / 1 RL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1880R / 2 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 277941 / 1 MO / PO

Administered by: Public      Purchased by: Unknown
Symptoms: Convulsion, Pyrexia, Tremor

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Allergies:
Diagnostic Lab Data: Lumbar puncture - results normal
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/OPV/Recomb developed fever of 103, convulsions, fine tremor.


Changed on 6/14/2018

VAERS ID: 26836 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Alaska
Vaccinated:1990-10-24
Onset:1990-10-24
Submitted:1990-11-06
Entered:1990-11-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 283913 / 1 RL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1880R / 2 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 277941 / 1 MO / PO

Administered by: Public      Purchased by: Unknown
Symptoms: Convulsion, Pyrexia, Tremor

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Allergies:
Diagnostic Lab Data: Lumbar puncture - results normal
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/OPV/Recomb developed fever of 103, convulsions, fine tremor.


Changed on 8/14/2018

VAERS ID: 26836 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Alaska
Vaccinated:1990-10-24
Onset:1990-10-24
Submitted:1990-11-06
Entered:1990-11-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 283913 / 1 RL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1880R / 2 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 277941 / 1 MO / PO

Administered by: Public      Purchased by: Unknown
Symptoms: Convulsion, Pyrexia, Tremor

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Allergies:
Diagnostic Lab Data: Lumbar puncture - results normal
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/OPV/Recomb developed fever of 103, convulsions, fine tremor.


Changed on 9/14/2018

VAERS ID: 26836 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Alaska
Vaccinated:1990-10-24
Onset:1990-10-24
Submitted:1990-11-06
Entered:1990-11-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 283913 / 1 RL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1880R / 2 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 277941 / 1 MO / PO

Administered by: Public      Purchased by: Unknown
Symptoms: Convulsion, Pyrexia, Tremor

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Allergies:
Diagnostic Lab Data: Lumbar puncture - results normal
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/OPV/Recomb developed fever of 103, convulsions, fine tremor.


Changed on 10/14/2018

VAERS ID: 26836 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Alaska
Vaccinated:1990-10-24
Onset:1990-10-24
Submitted:1990-11-06
Entered:1990-11-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 283913 / 1 RL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1880R / 2 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 277941 / 1 MO / PO

Administered by: Public      Purchased by: Unknown
Symptoms: Convulsion, Pyrexia, Tremor

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Allergies:
Diagnostic Lab Data: Lumbar puncture - results normal
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/OPV/Recomb developed fever of 103, convulsions, fine tremor.

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