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This is VAERS ID 28123

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 28123
VAERS Form:
Age:1.4
Sex:Female
Location:Oklahoma
Vaccinated:1990-02-06
Onset:1990-02-06
Submitted:0000-00-00
Entered:1991-02-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 256962 / - - / -
MMR: MMR II / MSD 1334R / - - / -
OPV: ORIMUNE / LEDERLE 0599B / - - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: RASH

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: No illness following previous immunization.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: CDC reports: 17 mo child developed a rash following DTP/OPV/MMR immun; Hospitalized 1 day.


Changed on 12/8/2009

VAERS ID: 28123 Before After
VAERS Form:
Age:1.4
Sex:Female
Location:Oklahoma
Vaccinated:1990-02-06
Onset:1990-02-06
Submitted:0000-00-00
Entered:1991-02-19 1991-02-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL DTP (TRI-IMMUNOL) / LEDERLE LEDERLE LABORATORIES 256962 / - - / -
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 1334R / - - / -
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES 0599B / - - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Rash, RASH

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: No illness following previous immunization.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) 900162803

Write-up: CDC reports: 17 mo child developed a rash following DTP/OPV/MMR immun; Hospitalized 1 day.


Changed on 5/14/2017

VAERS ID: 28123 Before After
VAERS Form:
Age:1.4
Sex:Female
Location:Oklahoma
Vaccinated:1990-02-06
Onset:1990-02-06
Submitted:0000-00-00
Entered:1991-02-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 256962 / - - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1334R / - - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 0599B / - - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
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: No illness following previous immunization.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 900162803

Write-up: CDC reports: 17 mo child developed a rash following DTP/OPV/MMR immun; Hospitalized 1 day.


Changed on 9/14/2017

VAERS ID: 28123 Before After
VAERS Form:(blank) 1
Age:1.4
Sex:Female
Location:Oklahoma
Vaccinated:1990-02-06
Onset:1990-02-06
Submitted:0000-00-00
Entered:1991-02-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 256962 / - UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1334R / - UNK - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0599B / - UNK - MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
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: No illness following previous immunization.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 900162803

Write-up: CDC reports: 17 mo child developed a rash following DTP/OPV/MMR immun; Hospitalized 1 day.


Changed on 2/14/2018

VAERS ID: 28123 Before After
VAERS Form:1
Age:1.4
Sex:Female
Location:Oklahoma
Vaccinated:1990-02-06
Onset:1990-02-06
Submitted:0000-00-00
Entered:1991-02-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 256962 / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1334R / UNK - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0599B / UNK MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
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: No illness following previous immunization.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 900162803

Write-up: CDC reports: 17 mo child developed a rash following DTP/OPV/MMR immun; Hospitalized 1 day.


Changed on 6/14/2018

VAERS ID: 28123 Before After
VAERS Form:1
Age:1.4
Sex:Female
Location:Oklahoma
Vaccinated:1990-02-06
Onset:1990-02-06
Submitted:0000-00-00
Entered:1991-02-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 256962 / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1334R / UNK - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0599B / UNK MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
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: No illness following previous immunization.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 900162803

Write-up: CDC reports: 17 mo child developed a rash following DTP/OPV/MMR immun; Hospitalized 1 day.


Changed on 8/14/2018

VAERS ID: 28123 Before After
VAERS Form:1
Age:1.4
Sex:Female
Location:Oklahoma
Vaccinated:1990-02-06
Onset:1990-02-06
Submitted:0000-00-00
Entered:1991-02-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 256962 / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1334R / UNK - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0599B / UNK MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
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: No illness following previous immunization.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 900162803

Write-up: CDC reports: 17 mo child developed a rash following DTP/OPV/MMR immun; Hospitalized 1 day.


Changed on 9/14/2018

VAERS ID: 28123 Before After
VAERS Form:1
Age:1.4
Sex:Female
Location:Oklahoma
Vaccinated:1990-02-06
Onset:1990-02-06
Submitted:0000-00-00
Entered:1991-02-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 256962 / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1334R / UNK - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0599B / UNK MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
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: No illness following previous immunization.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 900162803

Write-up: CDC reports: 17 mo child developed a rash following DTP/OPV/MMR immun; Hospitalized 1 day.


Changed on 10/14/2018

VAERS ID: 28123 Before After
VAERS Form:1
Age:1.4
Sex:Female
Location:Oklahoma
Vaccinated:1990-02-06
Onset:1990-02-06
Submitted:0000-00-00
Entered:1991-02-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 256962 / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1334R / UNK - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0599B / UNK MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
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: No illness following previous immunization.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 900162803

Write-up: CDC reports: 17 mo child developed a rash following DTP/OPV/MMR immun; Hospitalized 1 day.

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