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This is VAERS ID 26998

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 26998
VAERS Form:
Age:1.3
Sex:Female
Location:North Carolina
Vaccinated:1990-11-02
Onset:1990-11-04
Submitted:1990-11-06
Entered:1990-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 285919 / 3 LL / IM
HIBV: PROHIBIT / CONNAUGHT LABS 0A21092 / 0 LA / IM
MMR: MMR II / MSD 0696S / 0 RA / SC
OPV: ORIMUNE / LEDERLE 0613K / 2 - / PO

Administered by: Public      Purchased by: Unknown
Symptoms: AGITATION, FEVER, ASTHMA, BRONCHIOLITIS

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/OPV/MMR/HIB became irritable, crying, wheezing, fever 101, Taken to ER; breathing was stabilized transferred to another hosp dx bronchiolitis not believed to be vaccine related.


Changed on 12/8/2009

VAERS ID: 26998 Before After
VAERS Form:
Age:1.3
Sex:Female
Location:North Carolina
Vaccinated:1990-11-02
Onset:1990-11-04
Submitted:1990-11-06
Entered:1990-12-18 1990-12-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL DTP (TRI-IMMUNOL) / LEDERLE LEDERLE LABORATORIES 285919 / 3 LL / IM
HIBV: PROHIBIT HIB (PROHIBIT) / CONNAUGHT LABS CONNAUGHT LABORATORIES 0A21092 / 0 LA / IM
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 0696S / 0 RA / SC
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES 0613K / 2 - / PO

Administered by: Public      Purchased by: Unknown Public
Symptoms: Agitation, Asthma, Bronchiolitis, Pyrexia, AGITATION, FEVER, ASTHMA, BRONCHIOLITIS

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) NC90005

Write-up: Pt vaccinated with DTP/OPV/MMR/HIB became irritable, crying, wheezing, fever 101, Taken to ER; breathing was stabilized transferred to another hosp dx bronchiolitis not believed to be vaccine related.


Changed on 5/14/2017

VAERS ID: 26998 Before After
VAERS Form:
Age:1.3
Sex:Female
Location:North Carolina
Vaccinated:1990-11-02
Onset:1990-11-04
Submitted:1990-11-06
Entered:1990-12-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 285919 / 3 LL / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0A21092 / 0 LA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0696S / 0 RA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 0613K / 2 - / PO

Administered by: Public      Purchased by: Public
Symptoms: Agitation, Asthma, Bronchiolitis, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NC90005

Write-up: Pt vaccinated with DTP/OPV/MMR/HIB became irritable, crying, wheezing, fever 101, Taken to ER; breathing was stabilized transferred to another hosp dx bronchiolitis not believed to be vaccine related.


Changed on 9/14/2017

VAERS ID: 26998 Before After
VAERS Form:(blank) 1
Age:1.3
Sex:Female
Location:North Carolina
Vaccinated:1990-11-02
Onset:1990-11-04
Submitted:1990-11-06
Entered:1990-12-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 285919 / 3 4 LL / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0A21092 / 0 1 LA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0696S / 0 1 RA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0613K / 2 3 - MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Agitation, Asthma, Bronchiolitis, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NC90005

Write-up: Pt vaccinated with DTP/OPV/MMR/HIB became irritable, crying, wheezing, fever 101, Taken to ER; breathing was stabilized transferred to another hosp dx bronchiolitis not believed to be vaccine related.


Changed on 2/14/2018

VAERS ID: 26998 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:North Carolina
Vaccinated:1990-11-02
Onset:1990-11-04
Submitted:1990-11-06
Entered:1990-12-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 285919 / 4 LL / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0A21092 / 1 LA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0696S / 1 RA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0613K / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Agitation, Asthma, Bronchiolitis, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NC90005

Write-up: Pt vaccinated with DTP/OPV/MMR/HIB became irritable, crying, wheezing, fever 101, Taken to ER; breathing was stabilized transferred to another hosp dx bronchiolitis not believed to be vaccine related.


Changed on 6/14/2018

VAERS ID: 26998 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:North Carolina
Vaccinated:1990-11-02
Onset:1990-11-04
Submitted:1990-11-06
Entered:1990-12-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 285919 / 4 LL / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0A21092 / 1 LA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0696S / 1 RA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0613K / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Agitation, Asthma, Bronchiolitis, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NC90005

Write-up: Pt vaccinated with DTP/OPV/MMR/HIB became irritable, crying, wheezing, fever 101, Taken to ER; breathing was stabilized transferred to another hosp dx bronchiolitis not believed to be vaccine related.


Changed on 8/14/2018

VAERS ID: 26998 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:North Carolina
Vaccinated:1990-11-02
Onset:1990-11-04
Submitted:1990-11-06
Entered:1990-12-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 285919 / 4 LL / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0A21092 / 1 LA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0696S / 1 RA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0613K / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Agitation, Asthma, Bronchiolitis, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NC90005

Write-up: Pt vaccinated with DTP/OPV/MMR/HIB became irritable, crying, wheezing, fever 101, Taken to ER; breathing was stabilized transferred to another hosp dx bronchiolitis not believed to be vaccine related.


Changed on 9/14/2018

VAERS ID: 26998 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:North Carolina
Vaccinated:1990-11-02
Onset:1990-11-04
Submitted:1990-11-06
Entered:1990-12-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 285919 / 4 LL / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0A21092 / 1 LA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0696S / 1 RA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0613K / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Agitation, Asthma, Bronchiolitis, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NC90005

Write-up: Pt vaccinated with DTP/OPV/MMR/HIB became irritable, crying, wheezing, fever 101, Taken to ER; breathing was stabilized transferred to another hosp dx bronchiolitis not believed to be vaccine related.


Changed on 10/14/2018

VAERS ID: 26998 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:North Carolina
Vaccinated:1990-11-02
Onset:1990-11-04
Submitted:1990-11-06
Entered:1990-12-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 285919 / 4 LL / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0A21092 / 1 LA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0696S / 1 RA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0613K / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Agitation, Asthma, Bronchiolitis, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NC90005

Write-up: Pt vaccinated with DTP/OPV/MMR/HIB became irritable, crying, wheezing, fever 101, Taken to ER; breathing was stabilized transferred to another hosp dx bronchiolitis not believed to be vaccine related.

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