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This is VAERS ID 27507

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 27507
VAERS Form:
Age:1.3
Sex:Female
Location:Virginia
Vaccinated:1991-01-05
Onset:1991-01-05
Submitted:0000-00-00
Entered:1991-01-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 293947 / 2 LL / IM
MMR: MMR II / MSD 1492S / 0 RL / SC
OPV: ORIMUNE / LEDERLE 287949 / 2 - / PO

Administered by: Public      Purchased by: Unknown
Symptoms: FEVER, RASH, URTICARIA

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Blood Cultures; CBC WBC 20,000 Spinal tap - negative
CDC 'Split Type':

Write-up: Day of vac developed fever 103-104(F) lt leg at inj site red w/rash. Admitted to hosp. Tx w/IV & IM antibiotics. D/c''d on oral antibiotics 6JAN91. Rash fine red (like a hive) at inj site spread to lt buttock. 8Jan91, temp to 106.5


Changed on 12/8/2009

VAERS ID: 27507 Before After
VAERS Form:
Age:1.3
Sex:Female
Location:Virginia
Vaccinated:1991-01-05
Onset:1991-01-05
Submitted:0000-00-00
Entered:1991-01-24 1991-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL DTP (TRI-IMMUNOL) / LEDERLE LEDERLE LABORATORIES 293947 / 2 LL / IM
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 1492S / 0 RL / SC
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES 287949 / 2 - / PO

Administered by: Public      Purchased by: Unknown Public
Symptoms: Pyrexia, Rash, Urticaria, FEVER, RASH, URTICARIA

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Blood Cultures; CBC WBC 20,000 Spinal tap - negative
CDC 'Split Type': (blank) VA91002

Write-up: Day of vac developed fever 103-104(F) lt leg at inj site red w/rash. Admitted to hosp. Tx w/IV & IM antibiotics. D/c''d on oral antibiotics 6JAN91. Rash fine red (like a hive) at inj site spread to lt buttock. 8Jan91, temp to 106.5


Changed on 5/14/2017

VAERS ID: 27507 Before After
VAERS Form:
Age:1.3
Sex:Female
Location:Virginia
Vaccinated:1991-01-05
Onset:1991-01-05
Submitted:0000-00-00
Entered:1991-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 293947 / 2 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1492S / 0 RL / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 287949 / 2 - / PO

Administered by: Public      Purchased by: Public
Symptoms: Pyrexia, Rash, Urticaria

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Blood Cultures; CBC WBC 20,000 Spinal tap - negative
CDC 'Split Type': VA91002

Write-up: Day of vac developed fever 103-104(F) lt leg at inj site red w/rash. Admitted to hosp. Tx w/IV & IM antibiotics. D/c''d on oral antibiotics 6JAN91. Rash fine red (like a hive) at inj site spread to lt buttock. 8Jan91, temp to 106.5


Changed on 9/14/2017

VAERS ID: 27507 Before After
VAERS Form:(blank) 1
Age:1.3
Sex:Female
Location:Virginia
Vaccinated:1991-01-05
Onset:1991-01-05
Submitted:0000-00-00
Entered:1991-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 293947 / 2 3 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1492S / 0 1 RL / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 287949 / 2 3 - MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Pyrexia, Rash, Urticaria

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Blood Cultures; CBC WBC 20,000 Spinal tap - negative
CDC 'Split Type': VA91002

Write-up: Day of vac developed fever 103-104(F) lt leg at inj site red w/rash. Admitted to hosp. Tx w/IV & IM antibiotics. D/c''d on oral antibiotics 6JAN91. Rash fine red (like a hive) at inj site spread to lt buttock. 8Jan91, temp to 106.5


Changed on 2/14/2018

VAERS ID: 27507 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Virginia
Vaccinated:1991-01-05
Onset:1991-01-05
Submitted:0000-00-00
Entered:1991-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 293947 / 3 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1492S / 1 RL / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 287949 / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Pyrexia, Rash, Urticaria

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Blood Cultures; CBC WBC 20,000 Spinal tap - negative
CDC 'Split Type': VA91002

Write-up: Day of vac developed fever 103-104(F) lt leg at inj site red w/rash. Admitted to hosp. Tx w/IV & IM antibiotics. D/c''d on oral antibiotics 6JAN91. Rash fine red (like a hive) at inj site spread to lt buttock. 8Jan91, temp to 106.5


Changed on 6/14/2018

VAERS ID: 27507 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Virginia
Vaccinated:1991-01-05
Onset:1991-01-05
Submitted:0000-00-00
Entered:1991-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 293947 / 3 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1492S / 1 RL / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 287949 / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Pyrexia, Rash, Urticaria

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Blood Cultures; CBC WBC 20,000 Spinal tap - negative
CDC 'Split Type': VA91002

Write-up: Day of vac developed fever 103-104(F) lt leg at inj site red w/rash. Admitted to hosp. Tx w/IV & IM antibiotics. D/c''d on oral antibiotics 6JAN91. Rash fine red (like a hive) at inj site spread to lt buttock. 8Jan91, temp to 106.5


Changed on 8/14/2018

VAERS ID: 27507 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Virginia
Vaccinated:1991-01-05
Onset:1991-01-05
Submitted:0000-00-00
Entered:1991-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 293947 / 3 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1492S / 1 RL / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 287949 / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Pyrexia, Rash, Urticaria

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Blood Cultures; CBC WBC 20,000 Spinal tap - negative
CDC 'Split Type': VA91002

Write-up: Day of vac developed fever 103-104(F) lt leg at inj site red w/rash. Admitted to hosp. Tx w/IV & IM antibiotics. D/c''d on oral antibiotics 6JAN91. Rash fine red (like a hive) at inj site spread to lt buttock. 8Jan91, temp to 106.5


Changed on 9/14/2018

VAERS ID: 27507 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Virginia
Vaccinated:1991-01-05
Onset:1991-01-05
Submitted:0000-00-00
Entered:1991-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 293947 / 3 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1492S / 1 RL / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 287949 / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Pyrexia, Rash, Urticaria

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Blood Cultures; CBC WBC 20,000 Spinal tap - negative
CDC 'Split Type': VA91002

Write-up: Day of vac developed fever 103-104(F) lt leg at inj site red w/rash. Admitted to hosp. Tx w/IV & IM antibiotics. D/c''d on oral antibiotics 6JAN91. Rash fine red (like a hive) at inj site spread to lt buttock. 8Jan91, temp to 106.5


Changed on 10/14/2018

VAERS ID: 27507 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Virginia
Vaccinated:1991-01-05
Onset:1991-01-05
Submitted:0000-00-00
Entered:1991-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 293947 / 3 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1492S / 1 RL / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 287949 / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Pyrexia, Rash, Urticaria

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Blood Cultures; CBC WBC 20,000 Spinal tap - negative
CDC 'Split Type': VA91002

Write-up: Day of vac developed fever 103-104(F) lt leg at inj site red w/rash. Admitted to hosp. Tx w/IV & IM antibiotics. D/c''d on oral antibiotics 6JAN91. Rash fine red (like a hive) at inj site spread to lt buttock. 8Jan91, temp to 106.5

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