National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 27074

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 27074
VAERS Form:
Age:1.3
Sex:Female
Location:Mississippi
Vaccinated:1990-11-15
Onset:1990-11-15
Submitted:1990-11-19
Entered:1990-12-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 285967 / 3 LL / IM
MMR: MMR II / MSD 0016S / 0 RL / -
OPV: ORIMUNE / LEDERLE 283939 / 2 - / PO

Administered by: Public      Purchased by: Unknown
Symptoms: FEVER

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: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated w/DTP/OPV/MMR developed temp during night after injection called clinic referred to ER. admitted to hosp & placed under seizure precautions.


Changed on 12/8/2009

VAERS ID: 27074 Before After
VAERS Form:
Age:1.3
Sex:Female
Location:Mississippi
Vaccinated:1990-11-15
Onset:1990-11-15
Submitted:1990-11-19
Entered:1990-12-19 1990-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL DTP (TRI-IMMUNOL) / LEDERLE LEDERLE LABORATORIES 285967 / 3 LL / IM
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 0016S / 0 RL / -
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES 283939 / 2 - / PO

Administered by: Public      Purchased by: Unknown Public
Symptoms: Pyrexia, FEVER

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: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) MS904

Write-up: Pt vaccinated w/DTP/OPV/MMR developed temp during night after injection called clinic referred to ER. admitted to hosp & placed under seizure precautions.


Changed on 5/14/2017

VAERS ID: 27074 Before After
VAERS Form:
Age:1.3
Sex:Female
Location:Mississippi
Vaccinated:1990-11-15
Onset:1990-11-15
Submitted:1990-11-19
Entered:1990-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 285967 / 3 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0016S / 0 RL / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 283939 / 2 - / PO

Administered by: Public      Purchased by: Public
Symptoms: 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: 2     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': MS904

Write-up: Pt vaccinated w/DTP/OPV/MMR developed temp during night after injection called clinic referred to ER. admitted to hosp & placed under seizure precautions.


Changed on 9/14/2017

VAERS ID: 27074 Before After
VAERS Form:(blank) 1
Age:1.3
Sex:Female
Location:Mississippi
Vaccinated:1990-11-15
Onset:1990-11-15
Submitted:1990-11-19
Entered:1990-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 285967 / 3 4 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0016S / 0 1 RL / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 283939 / 2 3 - MO / PO

Administered by: Public      Purchased by: Public
Symptoms: 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: 2     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': MS904

Write-up: Pt vaccinated w/DTP/OPV/MMR developed temp during night after injection called clinic referred to ER. admitted to hosp & placed under seizure precautions.


Changed on 2/14/2018

VAERS ID: 27074 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Mississippi
Vaccinated:1990-11-15
Onset:1990-11-15
Submitted:1990-11-19
Entered:1990-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 285967 / 4 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0016S / 1 RL / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 283939 / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: 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: 2     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': MS904

Write-up: Pt vaccinated w/DTP/OPV/MMR developed temp during night after injection called clinic referred to ER. admitted to hosp & placed under seizure precautions.


Changed on 6/14/2018

VAERS ID: 27074 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Mississippi
Vaccinated:1990-11-15
Onset:1990-11-15
Submitted:1990-11-19
Entered:1990-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 285967 / 4 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0016S / 1 RL / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 283939 / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: 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: 2     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': MS904

Write-up: Pt vaccinated w/DTP/OPV/MMR developed temp during night after injection called clinic referred to ER. admitted to hosp & placed under seizure precautions.


Changed on 8/14/2018

VAERS ID: 27074 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Mississippi
Vaccinated:1990-11-15
Onset:1990-11-15
Submitted:1990-11-19
Entered:1990-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 285967 / 4 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0016S / 1 RL / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 283939 / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: 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: 2     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': MS904

Write-up: Pt vaccinated w/DTP/OPV/MMR developed temp during night after injection called clinic referred to ER. admitted to hosp & placed under seizure precautions.


Changed on 9/14/2018

VAERS ID: 27074 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Mississippi
Vaccinated:1990-11-15
Onset:1990-11-15
Submitted:1990-11-19
Entered:1990-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 285967 / 4 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0016S / 1 RL / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 283939 / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: 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: 2     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': MS904

Write-up: Pt vaccinated w/DTP/OPV/MMR developed temp during night after injection called clinic referred to ER. admitted to hosp & placed under seizure precautions.


Changed on 10/14/2018

VAERS ID: 27074 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Mississippi
Vaccinated:1990-11-15
Onset:1990-11-15
Submitted:1990-11-19
Entered:1990-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 285967 / 4 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0016S / 1 RL / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 283939 / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: 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: 2     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': MS904

Write-up: Pt vaccinated w/DTP/OPV/MMR developed temp during night after injection called clinic referred to ER. admitted to hosp & placed under seizure precautions.

New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=27074&WAYBACKHISTORY=ON


Copyright © 2019 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166