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This is VAERS ID 28500

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 28500
VAERS Form:
Age:1.6
Sex:Male
Location:Ohio
Vaccinated:1991-01-22
Onset:1991-01-22
Submitted:1991-02-26
Entered:1991-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP / CONNAUGHT LABS 0B21044 / 3 LL / IM
HIBV: HIBTITER / LEDERLE(PRAXIS) M670FH / 0 LL / IM
MMR: MMR II / MSD 2258S / 0 LA / SC
OPV: ORIMUNE / LEDERLE 285948 / 2 - / PO

Administered by: Public      Purchased by: Unknown
Symptoms: DYSPNEA, CONVULS GRAND MAL

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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: under investigation
CDC 'Split Type':

Write-up: Status epilepticus approx 60 min. Intubated. Intensive care unit.


Changed on 12/8/2009

VAERS ID: 28500 Before After
VAERS Form:
Age:1.6
Sex:Male
Location:Ohio
Vaccinated:1991-01-22
Onset:1991-01-22
Submitted:1991-02-26
Entered:1991-03-06 1991-02-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP DTP (NO BRAND NAME) / CONNAUGHT LABS CONNAUGHT LABORATORIES 0B21044 / 3 LL / IM
HIBV: HIBTITER HIB (HIBTITER) / LEDERLE(PRAXIS) LEDERLE PRAXSIS M670FH / 0 LL / IM
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 2258S / 0 LA / SC
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES 285948 / 2 - / PO

Administered by: Public      Purchased by: Unknown Public
Symptoms: Dyspnoea, Grand mal convulsion, DYSPNEA, CONVULS GRAND MAL

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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: under investigation
CDC 'Split Type':

Write-up: Status epilepticus approx 60 min. Intubated. Intensive care unit.


Changed on 5/14/2017

VAERS ID: 28500 Before After
VAERS Form:
Age:1.6
Sex:Male
Location:Ohio
Vaccinated:1991-01-22
Onset:1991-01-22
Submitted:1991-02-26
Entered:1991-02-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0B21044 / 3 LL / IM
HIBV: HIB (HIBTITER) / LEDERLE PRAXSIS PFIZER/WYETH M670FH / 0 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 2258S / 0 LA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 285948 / 2 - / PO

Administered by: Public      Purchased by: Public
Symptoms: Dyspnoea, Grand mal convulsion

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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: under investigation
CDC 'Split Type':

Write-up: Status epilepticus approx 60 min. Intubated. Intensive care unit.


Changed on 9/14/2017

VAERS ID: 28500 Before After
VAERS Form:(blank) 1
Age:1.6
Sex:Male
Location:Ohio
Vaccinated:1991-01-22
Onset:1991-01-22
Submitted:1991-02-26
Entered:1991-02-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0B21044 / 3 4 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M670FH / 0 1 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 2258S / 0 1 LA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 285948 / 2 3 - MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Dyspnoea, Grand mal convulsion

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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: under investigation
CDC 'Split Type':

Write-up: Status epilepticus approx 60 min. Intubated. Intensive care unit.


Changed on 2/14/2018

VAERS ID: 28500 Before After
VAERS Form:1
Age:1.6
Sex:Male
Location:Ohio
Vaccinated:1991-01-22
Onset:1991-01-22
Submitted:1991-02-26
Entered:1991-02-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0B21044 / 4 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M670FH / 1 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 2258S / 1 LA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 285948 / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Dyspnoea, Grand mal convulsion

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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: under investigation
CDC 'Split Type':

Write-up: Status epilepticus approx 60 min. Intubated. Intensive care unit.


Changed on 6/14/2018

VAERS ID: 28500 Before After
VAERS Form:1
Age:1.6
Sex:Male
Location:Ohio
Vaccinated:1991-01-22
Onset:1991-01-22
Submitted:1991-02-26
Entered:1991-02-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0B21044 / 4 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M670FH / 1 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 2258S / 1 LA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 285948 / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Dyspnoea, Grand mal convulsion

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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: under investigation
CDC 'Split Type':

Write-up: Status epilepticus approx 60 min. Intubated. Intensive care unit.


Changed on 8/14/2018

VAERS ID: 28500 Before After
VAERS Form:1
Age:1.6
Sex:Male
Location:Ohio
Vaccinated:1991-01-22
Onset:1991-01-22
Submitted:1991-02-26
Entered:1991-02-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0B21044 / 4 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M670FH / 1 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 2258S / 1 LA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 285948 / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Dyspnoea, Grand mal convulsion

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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: under investigation
CDC 'Split Type':

Write-up: Status epilepticus approx 60 min. Intubated. Intensive care unit.


Changed on 9/14/2018

VAERS ID: 28500 Before After
VAERS Form:1
Age:1.6
Sex:Male
Location:Ohio
Vaccinated:1991-01-22
Onset:1991-01-22
Submitted:1991-02-26
Entered:1991-02-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0B21044 / 4 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M670FH / 1 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 2258S / 1 LA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 285948 / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Dyspnoea, Grand mal convulsion

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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: under investigation
CDC 'Split Type':

Write-up: Status epilepticus approx 60 min. Intubated. Intensive care unit.


Changed on 10/14/2018

VAERS ID: 28500 Before After
VAERS Form:1
Age:1.6
Sex:Male
Location:Ohio
Vaccinated:1991-01-22
Onset:1991-01-22
Submitted:1991-02-26
Entered:1991-02-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0B21044 / 4 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M670FH / 1 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 2258S / 1 LA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 285948 / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Dyspnoea, Grand mal convulsion

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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: under investigation
CDC 'Split Type':

Write-up: Status epilepticus approx 60 min. Intubated. Intensive care unit.

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