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This is VAERS ID 29808

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 29808
VAERS Form:
Age:1.3
Sex:Male
Location:Illinois
Vaccinated:1991-03-01
Onset:1991-03-07
Submitted:1991-03-13
Entered:1991-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: PROHIBIT / CONNAUGHT LABS 0A21092 / 0 RL / IM
MMR: MMR II / MSD 1498S / 0 RA / SC

Administered by: Public      Purchased by: Unknown
Symptoms: AGITATION, CYANOSIS, APNEA, COUGH INC, FEBRILE SEIZURE

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Hx of infectious diseases- etc otitis media w/fever- URI & early bronchitis;
Allergies:
Diagnostic Lab Data: WBC 2900, 62lymphs, 36 segs; SGOT mildly elevated 52; chem 6;
CDC 'Split Type':

Write-up: 15mo old began having a febrile illness approx 8 days p/receiving his 1st MMR/HIB vax; temp to 102(ax) & febrile convuls; 2 days prior to admission pt began having sx of URI w/rhinitis, cough, congestion & fever worse apneic & cyanotic;


Changed on 12/8/2009

VAERS ID: 29808 Before After
VAERS Form:
Age:1.3
Sex:Male
Location:Illinois
Vaccinated:1991-03-01
Onset:1991-03-07
Submitted:1991-03-13
Entered:1991-04-15 1991-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: PROHIBIT HIB (PROHIBIT) / CONNAUGHT LABS CONNAUGHT LABORATORIES 0A21092 / 0 RL / IM
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 1498S / 0 RA / SC

Administered by: Public      Purchased by: Unknown Public
Symptoms: Agitation, Apnoea, Cough, Cyanosis, Febrile convulsion, Pyrexia, Rhinitis, AGITATION, CYANOSIS, APNEA, COUGH INC, FEBRILE SEIZURE

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Hx of infectious diseases- etc otitis media w/fever- URI & early bronchitis;
Allergies:
Diagnostic Lab Data: WBC 2900, 62lymphs, 36 segs; SGOT mildly elevated 52; chem 6;
CDC 'Split Type': (blank) IL9117

Write-up: 15mo old began having a febrile illness approx 8 days p/receiving his 1st MMR/HIB vax; temp to 102(ax) & febrile convuls; 2 days prior to admission pt began having sx of URI w/rhinitis, cough, congestion & fever worse apneic & cyanotic;


Changed on 5/14/2017

VAERS ID: 29808 Before After
VAERS Form:
Age:1.3
Sex:Male
Location:Illinois
Vaccinated:1991-03-01
Onset:1991-03-07
Submitted:1991-03-13
Entered:1991-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0A21092 / 0 RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1498S / 0 RA / SC

Administered by: Public      Purchased by: Public
Symptoms: Agitation, Apnoea, Cough, Cyanosis, Febrile convulsion, Pyrexia, Rhinitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Hx of infectious diseases- etc otitis media w/fever- URI & early bronchitis;
Allergies:
Diagnostic Lab Data: WBC 2900, 62lymphs, 36 segs; SGOT mildly elevated 52; chem 6;
CDC 'Split Type': IL9117

Write-up: 15mo old began having a febrile illness approx 8 days p/receiving his 1st MMR/HIB vax; temp to 102(ax) & febrile convuls; 2 days prior to admission pt began having sx of URI w/rhinitis, cough, congestion & fever worse apneic & cyanotic;


Changed on 9/14/2017

VAERS ID: 29808 Before After
VAERS Form:(blank) 1
Age:1.3
Sex:Male
Location:Illinois
Vaccinated:1991-03-01
Onset:1991-03-07
Submitted:1991-03-13
Entered:1991-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0A21092 / 0 1 RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1498S / 0 1 RA / SC

Administered by: Public      Purchased by: Public
Symptoms: Agitation, Apnoea, Cough, Cyanosis, Febrile convulsion, Pyrexia, Rhinitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Hx of infectious diseases- etc otitis media w/fever- URI & early bronchitis;
Allergies:
Diagnostic Lab Data: WBC 2900, 62lymphs, 36 segs; SGOT mildly elevated 52; chem 6;
CDC 'Split Type': IL9117

Write-up: 15mo old began having a febrile illness approx 8 days p/receiving his 1st MMR/HIB vax; temp to 102(ax) & febrile convuls; 2 days prior to admission pt began having sx of URI w/rhinitis, cough, congestion & fever worse apneic & cyanotic;


Changed on 2/14/2018

VAERS ID: 29808 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:Illinois
Vaccinated:1991-03-01
Onset:1991-03-07
Submitted:1991-03-13
Entered:1991-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0A21092 / 1 RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1498S / 1 RA / SC

Administered by: Public      Purchased by: Public
Symptoms: Agitation, Apnoea, Cough, Cyanosis, Febrile convulsion, Pyrexia, Rhinitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Hx of infectious diseases- etc otitis media w/fever- URI & early bronchitis;
Allergies:
Diagnostic Lab Data: WBC 2900, 62lymphs, 36 segs; SGOT mildly elevated 52; chem 6;
CDC 'Split Type': IL9117

Write-up: 15mo old began having a febrile illness approx 8 days p/receiving his 1st MMR/HIB vax; temp to 102(ax) & febrile convuls; 2 days prior to admission pt began having sx of URI w/rhinitis, cough, congestion & fever worse apneic & cyanotic;


Changed on 6/14/2018

VAERS ID: 29808 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:Illinois
Vaccinated:1991-03-01
Onset:1991-03-07
Submitted:1991-03-13
Entered:1991-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0A21092 / 1 RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1498S / 1 RA / SC

Administered by: Public      Purchased by: Public
Symptoms: Agitation, Apnoea, Cough, Cyanosis, Febrile convulsion, Pyrexia, Rhinitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Hx of infectious diseases- etc otitis media w/fever- URI & early bronchitis;
Allergies:
Diagnostic Lab Data: WBC 2900, 62lymphs, 36 segs; SGOT mildly elevated 52; chem 6;
CDC 'Split Type': IL9117

Write-up: 15mo old began having a febrile illness approx 8 days p/receiving his 1st MMR/HIB vax; temp to 102(ax) & febrile convuls; 2 days prior to admission pt began having sx of URI w/rhinitis, cough, congestion & fever worse apneic & cyanotic;


Changed on 8/14/2018

VAERS ID: 29808 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:Illinois
Vaccinated:1991-03-01
Onset:1991-03-07
Submitted:1991-03-13
Entered:1991-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0A21092 / 1 RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1498S / 1 RA / SC

Administered by: Public      Purchased by: Public
Symptoms: Agitation, Apnoea, Cough, Cyanosis, Febrile convulsion, Pyrexia, Rhinitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Hx of infectious diseases- etc otitis media w/fever- URI & early bronchitis;
Allergies:
Diagnostic Lab Data: WBC 2900, 62lymphs, 36 segs; SGOT mildly elevated 52; chem 6;
CDC 'Split Type': IL9117

Write-up: 15mo old began having a febrile illness approx 8 days p/receiving his 1st MMR/HIB vax; temp to 102(ax) & febrile convuls; 2 days prior to admission pt began having sx of URI w/rhinitis, cough, congestion & fever worse apneic & cyanotic;


Changed on 9/14/2018

VAERS ID: 29808 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:Illinois
Vaccinated:1991-03-01
Onset:1991-03-07
Submitted:1991-03-13
Entered:1991-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0A21092 / 1 RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1498S / 1 RA / SC

Administered by: Public      Purchased by: Public
Symptoms: Agitation, Apnoea, Cough, Cyanosis, Febrile convulsion, Pyrexia, Rhinitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Hx of infectious diseases- etc otitis media w/fever- URI & early bronchitis;
Allergies:
Diagnostic Lab Data: WBC 2900, 62lymphs, 36 segs; SGOT mildly elevated 52; chem 6;
CDC 'Split Type': IL9117

Write-up: 15mo old began having a febrile illness approx 8 days p/receiving his 1st MMR/HIB vax; temp to 102(ax) & febrile convuls; 2 days prior to admission pt began having sx of URI w/rhinitis, cough, congestion & fever worse apneic & cyanotic;


Changed on 10/14/2018

VAERS ID: 29808 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:Illinois
Vaccinated:1991-03-01
Onset:1991-03-07
Submitted:1991-03-13
Entered:1991-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0A21092 / 1 RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1498S / 1 RA / SC

Administered by: Public      Purchased by: Public
Symptoms: Agitation, Apnoea, Cough, Cyanosis, Febrile convulsion, Pyrexia, Rhinitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Hx of infectious diseases- etc otitis media w/fever- URI & early bronchitis;
Allergies:
Diagnostic Lab Data: WBC 2900, 62lymphs, 36 segs; SGOT mildly elevated 52; chem 6;
CDC 'Split Type': IL9117

Write-up: 15mo old began having a febrile illness approx 8 days p/receiving his 1st MMR/HIB vax; temp to 102(ax) & febrile convuls; 2 days prior to admission pt began having sx of URI w/rhinitis, cough, congestion & fever worse apneic & cyanotic;

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