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This is VAERS ID 28149

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 28149
VAERS Form:
Age:1.4
Sex:Female
Location:Louisiana
Vaccinated:1990-01-24
Onset:1990-01-24
Submitted:0000-00-00
Entered:1991-02-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 256965 / - - / -
MMR: MMR II / MSD 2064P / - - / -
OPV: ORIMUNE / LEDERLE 0542B / - - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: CONVULS, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: No illness following previous immunizations, no hx of convuls in pt, siblings, or parents.
Allergies:
Diagnostic Lab Data: EEG-WNL
CDC 'Split Type':

Write-up: 17 mo child developed fever to 103 & four convulsive episodes following DTP/OPV/MMR immunization. Hospitalized, EEG within normal limits according to pt mom. Pt on no anti-sz meds, duration of illness 4 days.


Changed on 12/8/2009

VAERS ID: 28149 Before After
VAERS Form:
Age:1.4
Sex:Female
Location:Louisiana
Vaccinated:1990-01-24
Onset:1990-01-24
Submitted:0000-00-00
Entered:1991-02-20 1991-02-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL DTP (TRI-IMMUNOL) / LEDERLE LEDERLE LABORATORIES 256965 / - - / -
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 2064P / - - / -
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES 0542B / - - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Convulsion, Pyrexia, CONVULS, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: No illness following previous immunizations, no hx of convuls in pt, siblings, or parents.
Allergies:
Diagnostic Lab Data: EEG-WNL
CDC 'Split Type': (blank) 900163003

Write-up: 17 mo child developed fever to 103 & four convulsive episodes following DTP/OPV/MMR immunization. Hospitalized, EEG within normal limits according to pt mom. Pt on no anti-sz meds, duration of illness 4 days.


Changed on 5/14/2017

VAERS ID: 28149 Before After
VAERS Form:
Age:1.4
Sex:Female
Location:Louisiana
Vaccinated:1990-01-24
Onset:1990-01-24
Submitted:0000-00-00
Entered:1991-02-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 256965 / - - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 2064P / - - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 0542B / - - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Convulsion, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: No illness following previous immunizations, no hx of convuls in pt, siblings, or parents.
Allergies:
Diagnostic Lab Data: EEG-WNL
CDC 'Split Type': 900163003

Write-up: 17 mo child developed fever to 103 & four convulsive episodes following DTP/OPV/MMR immunization. Hospitalized, EEG within normal limits according to pt mom. Pt on no anti-sz meds, duration of illness 4 days.


Changed on 9/14/2017

VAERS ID: 28149 Before After
VAERS Form:(blank) 1
Age:1.4
Sex:Female
Location:Louisiana
Vaccinated:1990-01-24
Onset:1990-01-24
Submitted:0000-00-00
Entered:1991-02-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 256965 / - UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 2064P / - UNK - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0542B / - UNK - MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Convulsion, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: No illness following previous immunizations, no hx of convuls in pt, siblings, or parents.
Allergies:
Diagnostic Lab Data: EEG-WNL
CDC 'Split Type': 900163003

Write-up: 17 mo child developed fever to 103 & four convulsive episodes following DTP/OPV/MMR immunization. Hospitalized, EEG within normal limits according to pt mom. Pt on no anti-sz meds, duration of illness 4 days.


Changed on 2/14/2018

VAERS ID: 28149 Before After
VAERS Form:1
Age:1.4
Sex:Female
Location:Louisiana
Vaccinated:1990-01-24
Onset:1990-01-24
Submitted:0000-00-00
Entered:1991-02-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 256965 / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 2064P / UNK - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0542B / UNK MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Convulsion, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: No illness following previous immunizations, no hx of convuls in pt, siblings, or parents.
Allergies:
Diagnostic Lab Data: EEG-WNL
CDC 'Split Type': 900163003

Write-up: 17 mo child developed fever to 103 & four convulsive episodes following DTP/OPV/MMR immunization. Hospitalized, EEG within normal limits according to pt mom. Pt on no anti-sz meds, duration of illness 4 days.


Changed on 6/14/2018

VAERS ID: 28149 Before After
VAERS Form:1
Age:1.4
Sex:Female
Location:Louisiana
Vaccinated:1990-01-24
Onset:1990-01-24
Submitted:0000-00-00
Entered:1991-02-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 256965 / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 2064P / UNK - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0542B / UNK MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Convulsion, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: No illness following previous immunizations, no hx of convuls in pt, siblings, or parents.
Allergies:
Diagnostic Lab Data: EEG-WNL
CDC 'Split Type': 900163003

Write-up: 17 mo child developed fever to 103 & four convulsive episodes following DTP/OPV/MMR immunization. Hospitalized, EEG within normal limits according to pt mom. Pt on no anti-sz meds, duration of illness 4 days.


Changed on 8/14/2018

VAERS ID: 28149 Before After
VAERS Form:1
Age:1.4
Sex:Female
Location:Louisiana
Vaccinated:1990-01-24
Onset:1990-01-24
Submitted:0000-00-00
Entered:1991-02-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 256965 / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 2064P / UNK - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0542B / UNK MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Convulsion, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: No illness following previous immunizations, no hx of convuls in pt, siblings, or parents.
Allergies:
Diagnostic Lab Data: EEG-WNL
CDC 'Split Type': 900163003

Write-up: 17 mo child developed fever to 103 & four convulsive episodes following DTP/OPV/MMR immunization. Hospitalized, EEG within normal limits according to pt mom. Pt on no anti-sz meds, duration of illness 4 days.


Changed on 9/14/2018

VAERS ID: 28149 Before After
VAERS Form:1
Age:1.4
Sex:Female
Location:Louisiana
Vaccinated:1990-01-24
Onset:1990-01-24
Submitted:0000-00-00
Entered:1991-02-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 256965 / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 2064P / UNK - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0542B / UNK MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Convulsion, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: No illness following previous immunizations, no hx of convuls in pt, siblings, or parents.
Allergies:
Diagnostic Lab Data: EEG-WNL
CDC 'Split Type': 900163003

Write-up: 17 mo child developed fever to 103 & four convulsive episodes following DTP/OPV/MMR immunization. Hospitalized, EEG within normal limits according to pt mom. Pt on no anti-sz meds, duration of illness 4 days.


Changed on 10/14/2018

VAERS ID: 28149 Before After
VAERS Form:1
Age:1.4
Sex:Female
Location:Louisiana
Vaccinated:1990-01-24
Onset:1990-01-24
Submitted:0000-00-00
Entered:1991-02-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 256965 / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 2064P / UNK - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0542B / UNK MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Convulsion, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: No illness following previous immunizations, no hx of convuls in pt, siblings, or parents.
Allergies:
Diagnostic Lab Data: EEG-WNL
CDC 'Split Type': 900163003

Write-up: 17 mo child developed fever to 103 & four convulsive episodes following DTP/OPV/MMR immunization. Hospitalized, EEG within normal limits according to pt mom. Pt on no anti-sz meds, duration of illness 4 days.

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