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This is VAERS ID 30860

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History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 30860
VAERS Form:
Age:0.3
Sex:Female
Location:Pennsylvania
Vaccinated:1991-04-22
Onset:1991-04-22
Submitted:1991-05-09
Entered:1991-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP / CONNAUGHT LABS 0B21044 / 1 LL / IM
HIBV: HIBTITER / LEDERLE(PRAXIS) M115HA / 1 RL / IM
IPV: POLIOVAX / CONNAUGHT LTD 841212 / 1 A / SC

Administered by: Private      Purchased by: Unknown
Symptoms: AGITATION, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Fever to 106 & mild irritability several hrs p/immun; Given acetaminophen; In office the following morning temp 101, exam otherwise normal;


Changed on 12/8/2009

VAERS ID: 30860 Before After
VAERS Form:
Age:0.3
Sex:Female
Location:Pennsylvania
Vaccinated:1991-04-22
Onset:1991-04-22
Submitted:1991-05-09
Entered:1991-06-03 1991-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP DTP (NO BRAND NAME) / CONNAUGHT LABS CONNAUGHT LABORATORIES 0B21044 / 1 LL / IM
HIBV: HIBTITER HIB (HIBTITER) / LEDERLE(PRAXIS) LEDERLE PRAXSIS M115HA / 1 RL / IM
IPV: POLIOVAX POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD CONNAUGHT LTD. 841212 / 1 A / SC

Administered by: Private      Purchased by: Unknown Private
Symptoms: Agitation, Pyrexia, AGITATION, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Fever to 106 & mild irritability several hrs p/immun; Given acetaminophen; In office the following morning temp 101, exam otherwise normal;


Changed on 5/14/2017

VAERS ID: 30860 Before After
VAERS Form:
Age:0.3
Sex:Female
Location:Pennsylvania
Vaccinated:1991-04-22
Onset:1991-04-22
Submitted:1991-05-09
Entered:1991-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0B21044 / 1 LL / IM
HIBV: HIB (HIBTITER) / LEDERLE PRAXSIS PFIZER/WYETH M115HA / 1 RL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. 841212 / 1 A - / SC SC A

Administered by: Private      Purchased by: Private
Symptoms: Agitation, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Fever to 106 & mild irritability several hrs p/immun; Given acetaminophen; In office the following morning temp 101, exam otherwise normal;


Changed on 9/14/2017

VAERS ID: 30860 Before After
VAERS Form:(blank) 1
Age:0.3
Sex:Female
Location:Pennsylvania
Vaccinated:1991-04-22
Onset:1991-04-22
Submitted:1991-05-09
Entered:1991-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0B21044 / 1 2 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M115HA / 1 2 RL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. 841212 / 1 2 - / SC A

Administered by: Private      Purchased by: Private
Symptoms: Agitation, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Fever to 106 & mild irritability several hrs p/immun; Given acetaminophen; In office the following morning temp 101, exam otherwise normal;


Changed on 2/14/2018

VAERS ID: 30860 Before After
VAERS Form:1
Age:0.3
Sex:Female
Location:Pennsylvania
Vaccinated:1991-04-22
Onset:1991-04-22
Submitted:1991-05-09
Entered:1991-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0B21044 / 2 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M115HA / 2 RL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. 841212 / 2 - / SC A

Administered by: Private      Purchased by: Private
Symptoms: Agitation, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Fever to 106 & mild irritability several hrs p/immun; Given acetaminophen; In office the following morning temp 101, exam otherwise normal;


Changed on 6/14/2018

VAERS ID: 30860 Before After
VAERS Form:1
Age:0.3
Sex:Female
Location:Pennsylvania
Vaccinated:1991-04-22
Onset:1991-04-22
Submitted:1991-05-09
Entered:1991-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0B21044 / 2 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M115HA / 2 RL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. 841212 / 2 - / SC A

Administered by: Private      Purchased by: Private
Symptoms: Agitation, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Fever to 106 & mild irritability several hrs p/immun; Given acetaminophen; In office the following morning temp 101, exam otherwise normal;


Changed on 8/14/2018

VAERS ID: 30860 Before After
VAERS Form:1
Age:0.3
Sex:Female
Location:Pennsylvania
Vaccinated:1991-04-22
Onset:1991-04-22
Submitted:1991-05-09
Entered:1991-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0B21044 / 2 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M115HA / 2 RL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. 841212 / 2 - / SC A

Administered by: Private      Purchased by: Private
Symptoms: Agitation, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Fever to 106 & mild irritability several hrs p/immun; Given acetaminophen; In office the following morning temp 101, exam otherwise normal;


Changed on 9/14/2018

VAERS ID: 30860 Before After
VAERS Form:1
Age:0.3
Sex:Female
Location:Pennsylvania
Vaccinated:1991-04-22
Onset:1991-04-22
Submitted:1991-05-09
Entered:1991-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0B21044 / 2 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M115HA / 2 RL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. 841212 / 2 - / SC A

Administered by: Private      Purchased by: Private
Symptoms: Agitation, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Fever to 106 & mild irritability several hrs p/immun; Given acetaminophen; In office the following morning temp 101, exam otherwise normal;


Changed on 10/14/2018

VAERS ID: 30860 Before After
VAERS Form:1
Age:0.3
Sex:Female
Location:Pennsylvania
Vaccinated:1991-04-22
Onset:1991-04-22
Submitted:1991-05-09
Entered:1991-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0B21044 / 2 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M115HA / 2 RL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. 841212 / 2 - / SC A

Administered by: Private      Purchased by: Private
Symptoms: Agitation, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Fever to 106 & mild irritability several hrs p/immun; Given acetaminophen; In office the following morning temp 101, exam otherwise normal;


Changed on 12/24/2020

VAERS ID: 30860 Before After
VAERS Form:1
Age:0.3
Sex:Female
Location:Pennsylvania
Vaccinated:1991-04-22
Onset:1991-04-22
Submitted:1991-05-09
Entered:1991-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0B21044 / 2 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M115HA / 2 RL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. 841212 / 2 - / SC A

Administered by: Private      Purchased by: Private
Symptoms: Agitation, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Fever to 106 & mild irritability several hrs p/immun; Given acetaminophen; In office the following morning temp 101, exam otherwise normal;


Changed on 12/30/2020

VAERS ID: 30860 Before After
VAERS Form:1
Age:0.3
Sex:Female
Location:Pennsylvania
Vaccinated:1991-04-22
Onset:1991-04-22
Submitted:1991-05-09
Entered:1991-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0B21044 / 2 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M115HA / 2 RL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. 841212 / 2 - / SC A

Administered by: Private      Purchased by: Private
Symptoms: Agitation, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Fever to 106 & mild irritability several hrs p/immun; Given acetaminophen; In office the following morning temp 101, exam otherwise normal;


Changed on 5/7/2021

VAERS ID: 30860 Before After
VAERS Form:1
Age:0.3
Sex:Female
Location:Pennsylvania
Vaccinated:1991-04-22
Onset:1991-04-22
Submitted:1991-05-09
Entered:1991-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0B21044 / 2 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M115HA / 2 RL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. 841212 / 2 - / SC A

Administered by: Private      Purchased by: Private
Symptoms: Agitation, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Fever to 106 & mild irritability several hrs p/immun; Given acetaminophen; In office the following morning temp 101, exam otherwise normal;


Changed on 5/14/2021

VAERS ID: 30860 Before After
VAERS Form:1
Age:0.3
Sex:Female
Location:Pennsylvania
Vaccinated:1991-04-22
Onset:1991-04-22
Submitted:1991-05-09
Entered:1991-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0B21044 / 2 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M115HA / 2 RL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. 841212 / 2 - / SC A

Administered by: Private      Purchased by: Private
Symptoms: Agitation, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Fever to 106 & mild irritability several hrs p/immun; Given acetaminophen; In office the following morning temp 101, exam otherwise normal;

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=30860&WAYBACKHISTORY=ON


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