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This is VAERS ID 39342

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 39342
VAERS Form:
Age:1.5
Sex:Female
Location:Washington
Vaccinated:1991-12-04
Onset:1991-12-31
Submitted:1992-01-08
Entered:1992-02-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 316976 / 2 - / IM
MMR: MMR II / MSD 1140T / 0 - / IM
OPV: ORIMUNE / LEDERLE 0641H / 2 - / PO

Administered by: Public      Purchased by: Unknown
Symptoms: AGITATION, FEVER, INFECT, PAIN BACK, MENINGITIS

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

Write-up: Meningitis dx one month p/giving MMR/DTP/OPV (bacterial?);


Changed on 12/8/2009

VAERS ID: 39342 Before After
VAERS Form:
Age:1.5
Sex:Female
Location:Washington
Vaccinated:1991-12-04
Onset:1991-12-31
Submitted:1992-01-08
Entered:1992-02-06 1992-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL DTP (TRI-IMMUNOL) / LEDERLE LEDERLE LABORATORIES 316976 / 2 - / IM
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 1140T / 0 - / IM
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES 0641H / 2 - / PO

Administered by: Public      Purchased by: Unknown Public
Symptoms: Agitation, Back pain, Infection, Meningitis, Neck pain, Pyrexia, AGITATION, FEVER, INFECT, PAIN BACK, MENINGITIS

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: 5     Extended hospital stay? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: sp tap
CDC 'Split Type': NONE WA92679

Write-up: Meningitis dx one month p/giving MMR/DTP/OPV (bacterial?);


Changed on 5/14/2017

VAERS ID: 39342 Before After
VAERS Form:
Age:1.5
Sex:Female
Location:Washington
Vaccinated:1991-12-04
Onset:1991-12-31
Submitted:1992-01-08
Entered:1992-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 316976 / 2 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1140T / 0 - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 0641H / 2 - / PO

Administered by: Public      Purchased by: Public
Symptoms: Agitation, Back pain, Infection, Meningitis, Neck pain, 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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations: NONE NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: sp tap
CDC 'Split Type': WA92679

Write-up: Meningitis dx one month p/giving MMR/DTP/OPV (bacterial?);


Changed on 9/14/2017

VAERS ID: 39342 Before After
VAERS Form:(blank) 1
Age:1.5
Sex:Female
Location:Washington
Vaccinated:1991-12-04
Onset:1991-12-31
Submitted:1992-01-08
Entered:1992-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 316976 / 2 3 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1140T / 0 1 - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0641H / 2 3 - MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Agitation, Back pain, Infection, Meningitis, Neck pain, 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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: sp tap
CDC 'Split Type': WA92679

Write-up: Meningitis dx one month p/giving MMR/DTP/OPV (bacterial?);


Changed on 2/14/2018

VAERS ID: 39342 Before After
VAERS Form:1
Age:1.5
Sex:Female
Location:Washington
Vaccinated:1991-12-04
Onset:1991-12-31
Submitted:1992-01-08
Entered:1992-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 316976 / 3 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1140T / 1 - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0641H / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Agitation, Back pain, Infection, Meningitis, Neck pain, 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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: sp tap
CDC 'Split Type': WA92679

Write-up: Meningitis dx one month p/giving MMR/DTP/OPV (bacterial?);


Changed on 6/14/2018

VAERS ID: 39342 Before After
VAERS Form:1
Age:1.5
Sex:Female
Location:Washington
Vaccinated:1991-12-04
Onset:1991-12-31
Submitted:1992-01-08
Entered:1992-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 316976 / 3 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1140T / 1 - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0641H / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Agitation, Back pain, Infection, Meningitis, Neck pain, 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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: sp tap
CDC 'Split Type': WA92679

Write-up: Meningitis dx one month p/giving MMR/DTP/OPV (bacterial?);


Changed on 8/14/2018

VAERS ID: 39342 Before After
VAERS Form:1
Age:1.5
Sex:Female
Location:Washington
Vaccinated:1991-12-04
Onset:1991-12-31
Submitted:1992-01-08
Entered:1992-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 316976 / 3 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1140T / 1 - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0641H / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Agitation, Back pain, Infection, Meningitis, Neck pain, 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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: sp tap
CDC 'Split Type': WA92679

Write-up: Meningitis dx one month p/giving MMR/DTP/OPV (bacterial?);


Changed on 9/14/2018

VAERS ID: 39342 Before After
VAERS Form:1
Age:1.5
Sex:Female
Location:Washington
Vaccinated:1991-12-04
Onset:1991-12-31
Submitted:1992-01-08
Entered:1992-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 316976 / 3 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1140T / 1 - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0641H / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Agitation, Back pain, Infection, Meningitis, Neck pain, 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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: sp tap
CDC 'Split Type': WA92679

Write-up: Meningitis dx one month p/giving MMR/DTP/OPV (bacterial?);


Changed on 10/14/2018

VAERS ID: 39342 Before After
VAERS Form:1
Age:1.5
Sex:Female
Location:Washington
Vaccinated:1991-12-04
Onset:1991-12-31
Submitted:1992-01-08
Entered:1992-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 316976 / 3 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1140T / 1 - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0641H / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Agitation, Back pain, Infection, Meningitis, Neck pain, 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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: sp tap
CDC 'Split Type': WA92679

Write-up: Meningitis dx one month p/giving MMR/DTP/OPV (bacterial?);

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