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This is VAERS ID 27521

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 27521
VAERS Form:
Age:0.5
Sex:Female
Location:California
Vaccinated:1991-01-15
Onset:1991-01-15
Submitted:1991-01-16
Entered:1991-01-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 295973 / 2 LA / IM
HEP: ENGERIX-B / SMITHKLINE 36560 / 2 RL / IM
HIBV: HIBTITER / LEDERLE(PRAXIS) M025FC / 1 RL / IM
OPV: ORIMUNE / LEDERLE 285951 / 2 - / PO

Administered by: Private      Purchased by: Unknown
Symptoms: EDEMA INJECT SITE, INJECT SITE REACT, RASH

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

Write-up: Immediate rxn, moderate erythema & local swelling size of small orange, ice applied given Tylenol. Rxn at DPT site, HIB site & Hepatitis B site - same rxn for all, same tmt.


Changed on 12/8/2009

VAERS ID: 27521 Before After
VAERS Form:
Age:0.5
Sex:Female
Location:California
Vaccinated:1991-01-15
Onset:1991-01-15
Submitted:1991-01-16
Entered:1991-01-25 1991-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL DTP (TRI-IMMUNOL) / LEDERLE LEDERLE LABORATORIES 295973 / 2 LA / IM
HEP: ENGERIX-B HEP B (ENGERIX-B) / SMITHKLINE SMITHKLINE BEECHAM 36560 / 2 RL / IM
HIBV: HIBTITER HIB (HIBTITER) / LEDERLE(PRAXIS) LEDERLE PRAXSIS M025FC / 1 RL / IM
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES 285951 / 2 - / PO

Administered by: Private      Purchased by: Unknown Private
Symptoms: Injection site oedema, Injection site reaction, Rash, EDEMA INJECT SITE, INJECT SITE REACT, RASH

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

Write-up: Immediate rxn, moderate erythema & local swelling size of small orange, ice applied given Tylenol. Rxn at DPT site, HIB site & Hepatitis B site - same rxn for all, same tmt.


Changed on 5/14/2017

VAERS ID: 27521 Before After
VAERS Form:
Age:0.5
Sex:Female
Location:California
Vaccinated:1991-01-15
Onset:1991-01-15
Submitted:1991-01-16
Entered:1991-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 295973 / 2 LA / IM
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 36560 / 2 RL / IM
HIBV: HIB (HIBTITER) / LEDERLE PRAXSIS PFIZER/WYETH M025FC / 1 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 285951 / 2 - / PO

Administered by: Private      Purchased by: Private
Symptoms: Injection site oedema, Injection site reaction, Rash

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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Immediate rxn, moderate erythema & local swelling size of small orange, ice applied given Tylenol. Rxn at DPT site, HIB site & Hepatitis B site - same rxn for all, same tmt.


Changed on 9/14/2017

VAERS ID: 27521 Before After
VAERS Form:(blank) 1
Age:0.5
Sex:Female
Location:California
Vaccinated:1991-01-15
Onset:1991-01-15
Submitted:1991-01-16
Entered:1991-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 295973 / 2 3 LA / IM
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 36560 / 2 3 RL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M025FC / 1 2 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 285951 / 2 3 - MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Injection site oedema, Injection site reaction, Rash

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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Immediate rxn, moderate erythema & local swelling size of small orange, ice applied given Tylenol. Rxn at DPT site, HIB site & Hepatitis B site - same rxn for all, same tmt.


Changed on 2/14/2018

VAERS ID: 27521 Before After
VAERS Form:1
Age:0.5
Sex:Female
Location:California
Vaccinated:1991-01-15
Onset:1991-01-15
Submitted:1991-01-16
Entered:1991-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 295973 / 3 LA / IM
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 36560 / 3 RL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M025FC / 2 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 285951 / 3 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Injection site oedema, Injection site reaction, Rash

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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Immediate rxn, moderate erythema & local swelling size of small orange, ice applied given Tylenol. Rxn at DPT site, HIB site & Hepatitis B site - same rxn for all, same tmt.


Changed on 6/14/2018

VAERS ID: 27521 Before After
VAERS Form:1
Age:0.5
Sex:Female
Location:California
Vaccinated:1991-01-15
Onset:1991-01-15
Submitted:1991-01-16
Entered:1991-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 295973 / 3 LA / IM
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 36560 / 3 RL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M025FC / 2 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 285951 / 3 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Injection site oedema, Injection site reaction, Rash

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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Immediate rxn, moderate erythema & local swelling size of small orange, ice applied given Tylenol. Rxn at DPT site, HIB site & Hepatitis B site - same rxn for all, same tmt.


Changed on 8/14/2018

VAERS ID: 27521 Before After
VAERS Form:1
Age:0.5
Sex:Female
Location:California
Vaccinated:1991-01-15
Onset:1991-01-15
Submitted:1991-01-16
Entered:1991-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 295973 / 3 LA / IM
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 36560 / 3 RL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M025FC / 2 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 285951 / 3 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Injection site oedema, Injection site reaction, Rash

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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Immediate rxn, moderate erythema & local swelling size of small orange, ice applied given Tylenol. Rxn at DPT site, HIB site & Hepatitis B site - same rxn for all, same tmt.


Changed on 9/14/2018

VAERS ID: 27521 Before After
VAERS Form:1
Age:0.5
Sex:Female
Location:California
Vaccinated:1991-01-15
Onset:1991-01-15
Submitted:1991-01-16
Entered:1991-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 295973 / 3 LA / IM
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 36560 / 3 RL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M025FC / 2 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 285951 / 3 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Injection site oedema, Injection site reaction, Rash

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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Immediate rxn, moderate erythema & local swelling size of small orange, ice applied given Tylenol. Rxn at DPT site, HIB site & Hepatitis B site - same rxn for all, same tmt.


Changed on 10/14/2018

VAERS ID: 27521 Before After
VAERS Form:1
Age:0.5
Sex:Female
Location:California
Vaccinated:1991-01-15
Onset:1991-01-15
Submitted:1991-01-16
Entered:1991-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 295973 / 3 LA / IM
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 36560 / 3 RL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M025FC / 2 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 285951 / 3 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Injection site oedema, Injection site reaction, Rash

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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Immediate rxn, moderate erythema & local swelling size of small orange, ice applied given Tylenol. Rxn at DPT site, HIB site & Hepatitis B site - same rxn for all, same tmt.

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