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This is VAERS ID 39339

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 39339
VAERS Form:
Age:1.3
Sex:Male
Location:Washington
Vaccinated:1992-01-06
Onset:1992-01-09
Submitted:1992-01-10
Entered:1992-02-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIBTITER / LEDERLE(PRAXIS) M160HH / - A / IM
MMR: MMR II / MSD 1368T / 0 A / SC

Administered by: Private      Purchased by: Unknown
Symptoms: CONVULS, FEVER, VOMIT, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: LP, BC
CDC 'Split Type':

Write-up: 3 days p/vax fever & vomiting 24 hrs later sz requiring admission to hosp;


Changed on 12/8/2009

VAERS ID: 39339 Before After
VAERS Form:
Age:1.3
Sex:Male
Location:Washington
Vaccinated:1992-01-06
Onset:1992-01-09
Submitted:1992-01-10
Entered:1992-02-06 1992-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIBTITER HIB (HIBTITER) / LEDERLE(PRAXIS) LEDERLE PRAXSIS M160HH / - A / IM
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 1368T / 0 A / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion, Febrile convulsion, Pyrexia, Vomiting, CONVULS, FEVER, VOMIT, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: LP, BC
CDC 'Split Type': (blank) WA92676

Write-up: 3 days p/vax fever & vomiting 24 hrs later sz requiring admission to hosp;


Changed on 5/14/2017

VAERS ID: 39339 Before After
VAERS Form:
Age:1.3
Sex:Male
Location:Washington
Vaccinated:1992-01-06
Onset:1992-01-09
Submitted:1992-01-10
Entered:1992-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / LEDERLE PRAXSIS PFIZER/WYETH M160HH / - A - / IM IM A
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1368T / 0 A - / SC SC A

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion, Febrile convulsion, Pyrexia, Vomiting

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: 2     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: LP, BC
CDC 'Split Type': WA92676

Write-up: 3 days p/vax fever & vomiting 24 hrs later sz requiring admission to hosp;


Changed on 9/14/2017

VAERS ID: 39339 Before After
VAERS Form:(blank) 1
Age:1.3
Sex:Male
Location:Washington
Vaccinated:1992-01-06
Onset:1992-01-09
Submitted:1992-01-10
Entered:1992-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH M160HH / - UNK - / IM A
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1368T / 0 1 - / SC A

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion, Febrile convulsion, Pyrexia, Vomiting

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: 2     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: LP, BC
CDC 'Split Type': WA92676

Write-up: 3 days p/vax fever & vomiting 24 hrs later sz requiring admission to hosp;


Changed on 2/14/2018

VAERS ID: 39339 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:Washington
Vaccinated:1992-01-06
Onset:1992-01-09
Submitted:1992-01-10
Entered:1992-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH M160HH / UNK - / IM A
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1368T / 1 - / SC A

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion, Febrile convulsion, Pyrexia, Vomiting

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: 2     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: LP, BC
CDC 'Split Type': WA92676

Write-up: 3 days p/vax fever & vomiting 24 hrs later sz requiring admission to hosp;


Changed on 6/14/2018

VAERS ID: 39339 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:Washington
Vaccinated:1992-01-06
Onset:1992-01-09
Submitted:1992-01-10
Entered:1992-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH M160HH / UNK - / IM A
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1368T / 1 - / SC A

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion, Febrile convulsion, Pyrexia, Vomiting

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: 2     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: LP, BC
CDC 'Split Type': WA92676

Write-up: 3 days p/vax fever & vomiting 24 hrs later sz requiring admission to hosp;


Changed on 8/14/2018

VAERS ID: 39339 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:Washington
Vaccinated:1992-01-06
Onset:1992-01-09
Submitted:1992-01-10
Entered:1992-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH M160HH / UNK - / IM A
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1368T / 1 - / SC A

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion, Febrile convulsion, Pyrexia, Vomiting

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: 2     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: LP, BC
CDC 'Split Type': WA92676

Write-up: 3 days p/vax fever & vomiting 24 hrs later sz requiring admission to hosp;


Changed on 9/14/2018

VAERS ID: 39339 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:Washington
Vaccinated:1992-01-06
Onset:1992-01-09
Submitted:1992-01-10
Entered:1992-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH M160HH / UNK - / IM A
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1368T / 1 - / SC A

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion, Febrile convulsion, Pyrexia, Vomiting

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: 2     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: LP, BC
CDC 'Split Type': WA92676

Write-up: 3 days p/vax fever & vomiting 24 hrs later sz requiring admission to hosp;


Changed on 10/14/2018

VAERS ID: 39339 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:Washington
Vaccinated:1992-01-06
Onset:1992-01-09
Submitted:1992-01-10
Entered:1992-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH M160HH / UNK - / IM A
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1368T / 1 - / SC A

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion, Febrile convulsion, Pyrexia, Vomiting

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: 2     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: LP, BC
CDC 'Split Type': WA92676

Write-up: 3 days p/vax fever & vomiting 24 hrs later sz requiring admission to hosp;

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=39339&WAYBACKHISTORY=ON


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