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This is VAERS ID 39572

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 39572
VAERS Form:
Age:2.7
Sex:Male
Location:California
Vaccinated:1990-07-27
Onset:1990-08-03
Submitted:1991-06-07
Entered:1992-02-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP / CONNAUGHT LABS 283913 / 0 LA / IM
MMR: MMR II / MSD 0436S / 0 RA / SC
OPV: ORIMUNE / LEDERLE 0606D / 0 - / PO

Administered by: Public      Purchased by: Unknown
Symptoms: HYPOTONIA, FEVER, ARTHRALGIA, ANOREXIA, ABDO ENLARGE

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 120     Extended hospital stay? No
Previous Vaccinations: pt had no hx of prior vax;
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: dx poss viral meningitis;
CDC 'Split Type': NONE

Write-up: 2 days prior immun pt devel apparently moderate fever (temp not taken) which fluctuated; 7 days post vax pt exp loss of appetite was listless & c/o inability to walk; wrists, ankles & feet hurting; body was flaccid & abdo was distended;


Changed on 12/8/2009

VAERS ID: 39572 Before After
VAERS Form:
Age:2.7
Sex:Male
Location:California
Vaccinated:1990-07-27
Onset:1990-08-03
Submitted:1991-06-07
Entered:1992-02-21 1992-02-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP DTP (NO BRAND NAME) / CONNAUGHT LABS CONNAUGHT LABORATORIES 283913 / 0 LA / IM
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 0436S / 0 RA / SC
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES 0606D / 0 - / PO

Administered by: Public      Purchased by: Unknown Public
Symptoms: Abdominal distension, Anorexia, Arthralgia, Hypotonia, Infection, Meningitis, Paralysis, Pyrexia, HYPOTONIA, FEVER, ARTHRALGIA, ANOREXIA, ABDO ENLARGE

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 120     Extended hospital stay? No
Previous Vaccinations: pt had no hx of prior vax;
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: dx poss viral meningitis;
CDC 'Split Type': NONE CA9216

Write-up: 2 days prior immun pt devel apparently moderate fever (temp not taken) which fluctuated; 7 days post vax pt exp loss of appetite was listless & c/o inability to walk; wrists, ankles & feet hurting; body was flaccid & abdo was distended;


Changed on 2/14/2017

VAERS ID: 39572 Before After
VAERS Form:
Age:2.7 2.0
Sex:Male
Location:California
Vaccinated:1990-07-27
Onset:1990-08-03
Submitted:1991-06-07
Entered:1992-02-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 283913 / 0 LA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0436S / 0 RA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES 0606D / 0 - / PO

Administered by: Public      Purchased by: Public
Symptoms: Abdominal distension, Anorexia, Arthralgia, Hypotonia, Infection, Meningitis, Paralysis, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 120     Extended hospital stay? No
Previous Vaccinations: pt had no hx of prior vax;
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: dx poss viral meningitis;
CDC 'Split Type': CA9216

Write-up: 2 days prior immun pt devel apparently moderate fever (temp not taken) which fluctuated; 7 days post vax pt exp loss of appetite was listless & c/o inability to walk; wrists, ankles & feet hurting; body was flaccid & abdo was distended;


Changed on 5/14/2017

VAERS ID: 39572 Before After
VAERS Form:
Age:2.0
Sex:Male
Location:California
Vaccinated:1990-07-27
Onset:1990-08-03
Submitted:1991-06-07
Entered:1992-02-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 283913 / 0 LA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0436S / 0 RA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 0606D / 0 - / PO

Administered by: Public      Purchased by: Public
Symptoms: Abdominal distension, Anorexia, Arthralgia, Hypotonia, Infection, Meningitis, Paralysis, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 120     Extended hospital stay? No
Previous Vaccinations: pt had no hx of prior vax; vax;~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: dx poss viral meningitis;
CDC 'Split Type': CA9216

Write-up: 2 days prior immun pt devel apparently moderate fever (temp not taken) which fluctuated; 7 days post vax pt exp loss of appetite was listless & c/o inability to walk; wrists, ankles & feet hurting; body was flaccid & abdo was distended;


Changed on 9/14/2017

VAERS ID: 39572 Before After
VAERS Form:(blank) 1
Age:2.0
Sex:Male
Location:California
Vaccinated:1990-07-27
Onset:1990-08-03
Submitted:1991-06-07
Entered:1992-02-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 283913 / 0 1 LA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0436S / 0 1 RA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0606D / 0 1 - MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Abdominal distension, Anorexia, Arthralgia, Hypotonia, Infection, Meningitis, Paralysis, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 120     Extended hospital stay? No
Previous Vaccinations: pt had no hx of prior vax;~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: dx poss viral meningitis;
CDC 'Split Type': CA9216

Write-up: 2 days prior immun pt devel apparently moderate fever (temp not taken) which fluctuated; 7 days post vax pt exp loss of appetite was listless & c/o inability to walk; wrists, ankles & feet hurting; body was flaccid & abdo was distended;


Changed on 2/14/2018

VAERS ID: 39572 Before After
VAERS Form:1
Age:2.0
Sex:Male
Location:California
Vaccinated:1990-07-27
Onset:1990-08-03
Submitted:1991-06-07
Entered:1992-02-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 283913 / 1 LA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0436S / 1 RA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0606D / 1 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Abdominal distension, Anorexia, Arthralgia, Hypotonia, Infection, Meningitis, Paralysis, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 120     Extended hospital stay? No
Previous Vaccinations: pt had no hx of prior vax;~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: dx poss viral meningitis;
CDC 'Split Type': CA9216

Write-up: 2 days prior immun pt devel apparently moderate fever (temp not taken) which fluctuated; 7 days post vax pt exp loss of appetite was listless & c/o inability to walk; wrists, ankles & feet hurting; body was flaccid & abdo was distended;


Changed on 6/14/2018

VAERS ID: 39572 Before After
VAERS Form:1
Age:2.0
Sex:Male
Location:California
Vaccinated:1990-07-27
Onset:1990-08-03
Submitted:1991-06-07
Entered:1992-02-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 283913 / 1 LA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0436S / 1 RA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0606D / 1 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Abdominal distension, Anorexia, Arthralgia, Hypotonia, Infection, Meningitis, Paralysis, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 120     Extended hospital stay? No
Previous Vaccinations: pt had no hx of prior vax;~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: dx poss viral meningitis;
CDC 'Split Type': CA9216

Write-up: 2 days prior immun pt devel apparently moderate fever (temp not taken) which fluctuated; 7 days post vax pt exp loss of appetite was listless & c/o inability to walk; wrists, ankles & feet hurting; body was flaccid & abdo was distended;


Changed on 8/14/2018

VAERS ID: 39572 Before After
VAERS Form:1
Age:2.0
Sex:Male
Location:California
Vaccinated:1990-07-27
Onset:1990-08-03
Submitted:1991-06-07
Entered:1992-02-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 283913 / 1 LA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0436S / 1 RA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0606D / 1 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Abdominal distension, Anorexia, Arthralgia, Hypotonia, Infection, Meningitis, Paralysis, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 120     Extended hospital stay? No
Previous Vaccinations: pt had no hx of prior vax;~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: dx poss viral meningitis;
CDC 'Split Type': CA9216

Write-up: 2 days prior immun pt devel apparently moderate fever (temp not taken) which fluctuated; 7 days post vax pt exp loss of appetite was listless & c/o inability to walk; wrists, ankles & feet hurting; body was flaccid & abdo was distended;


Changed on 9/14/2018

VAERS ID: 39572 Before After
VAERS Form:1
Age:2.0
Sex:Male
Location:California
Vaccinated:1990-07-27
Onset:1990-08-03
Submitted:1991-06-07
Entered:1992-02-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 283913 / 1 LA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0436S / 1 RA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0606D / 1 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Abdominal distension, Anorexia, Arthralgia, Hypotonia, Infection, Meningitis, Paralysis, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 120     Extended hospital stay? No
Previous Vaccinations: pt had no hx of prior vax;~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: dx poss viral meningitis;
CDC 'Split Type': CA9216

Write-up: 2 days prior immun pt devel apparently moderate fever (temp not taken) which fluctuated; 7 days post vax pt exp loss of appetite was listless & c/o inability to walk; wrists, ankles & feet hurting; body was flaccid & abdo was distended;


Changed on 10/14/2018

VAERS ID: 39572 Before After
VAERS Form:1
Age:2.0
Sex:Male
Location:California
Vaccinated:1990-07-27
Onset:1990-08-03
Submitted:1991-06-07
Entered:1992-02-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 283913 / 1 LA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0436S / 1 RA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0606D / 1 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Abdominal distension, Anorexia, Arthralgia, Hypotonia, Infection, Meningitis, Paralysis, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 120     Extended hospital stay? No
Previous Vaccinations: pt had no hx of prior vax;~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: dx poss viral meningitis;
CDC 'Split Type': CA9216

Write-up: 2 days prior immun pt devel apparently moderate fever (temp not taken) which fluctuated; 7 days post vax pt exp loss of appetite was listless & c/o inability to walk; wrists, ankles & feet hurting; body was flaccid & abdo was distended;

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