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This is VAERS ID 39747

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 39747
VAERS Form:
Age:0.5
Sex:Female
Location:Hawaii
Vaccinated:1991-12-17
Onset:1991-12-17
Submitted:1991-12-23
Entered:1992-03-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 304922 / 2 RL / -
HEP: HEPTAVAX / MSD 0169T / 1 LL / -
HIBV: HIBTITER / LEDERLE(PRAXIS) M125HF / 2 LL / -

Administered by: Public      Purchased by: Unknown
Symptoms: 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: runny nose past 3 days
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CXR, Blood test
CDC 'Split Type':

Write-up: Pt devel t102 fever aobut 5PM on day of immun which continued throughout next 48 hrs inspite of APAP, liquids, & frequent warm showers; Seen by MD 19DEC91 fever continued elevating to 104.8 & revisited MD; exam by MD 20DEC91 CXR & lab work;


Changed on 12/8/2009

VAERS ID: 39747 Before After
VAERS Form:
Age:0.5
Sex:Female
Location:Hawaii
Vaccinated:1991-12-17
Onset:1991-12-17
Submitted:1991-12-23
Entered:1992-03-04 1992-03-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL DTP (TRI-IMMUNOL) / LEDERLE LEDERLE LABORATORIES 304922 / 2 RL / -
HEP: HEPTAVAX HEP B (HEPTAVAX) / MSD MERCK & CO. INC. 0169T / 1 LL / -
HIBV: HIBTITER HIB (HIBTITER) / LEDERLE(PRAXIS) LEDERLE PRAXSIS M125HF / 2 LL / -

Administered by: Public      Purchased by: Unknown Public
Symptoms: Pyrexia, 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: runny nose past 3 days
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CXR, Blood test
CDC 'Split Type': (blank) HI9207

Write-up: Pt devel t102 fever aobut 5PM on day of immun which continued throughout next 48 hrs inspite of APAP, liquids, & frequent warm showers; Seen by MD 19DEC91 fever continued elevating to 104.8 & revisited MD; exam by MD 20DEC91 CXR & lab work;


Changed on 8/31/2010

VAERS ID: 39747 Before After
VAERS Form:
Age:0.5
Sex:Female
Location:Hawaii
Vaccinated:1991-12-17
Onset:1991-12-17
Submitted:1991-12-23
Entered:1992-03-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 304922 / 2 RL / -
HEP: HEP B (HEPTAVAX) HEP B (FOREIGN) / MERCK & CO. INC. 0169T / 1 LL / -
HIBV: HIB (HIBTITER) / LEDERLE PRAXSIS M125HF / 2 LL / -

Administered by: Public      Purchased by: Public
Symptoms: 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:
Other Medications:
Current Illness: runny nose past 3 days
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CXR, Blood test
CDC 'Split Type': HI9207

Write-up: Pt devel t102 fever aobut 5PM on day of immun which continued throughout next 48 hrs inspite of APAP, liquids, & frequent warm showers; Seen by MD 19DEC91 fever continued elevating to 104.8 & revisited MD; exam by MD 20DEC91 CXR & lab work;


Changed on 5/14/2017

VAERS ID: 39747 Before After
VAERS Form:
Age:0.5
Sex:Female
Location:Hawaii
Vaccinated:1991-12-17
Onset:1991-12-17
Submitted:1991-12-23
Entered:1992-03-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 304922 / 2 RL / -
HEP: HEP B (FOREIGN) / MERCK & CO. INC. 0169T / 1 LL / -
HIBV: HIB (HIBTITER) / LEDERLE PRAXSIS PFIZER/WYETH M125HF / 2 LL / -

Administered by: Public      Purchased by: Public
Symptoms: 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: runny nose past 3 days
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CXR, Blood test
CDC 'Split Type': HI9207

Write-up: Pt devel t102 fever aobut 5PM on day of immun which continued throughout next 48 hrs inspite of APAP, liquids, & frequent warm showers; Seen by MD 19DEC91 fever continued elevating to 104.8 & revisited MD; exam by MD 20DEC91 CXR & lab work;


Changed on 9/14/2017

VAERS ID: 39747 Before After
VAERS Form:(blank) 1
Age:0.5
Sex:Female
Location:Hawaii
Vaccinated:1991-12-17
Onset:1991-12-17
Submitted:1991-12-23
Entered:1992-03-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 304922 / 2 3 RL / -
HEP: HEP B (FOREIGN) / MERCK & CO. INC. 0169T / 1 2 LL / -
HIBV: HIB (HIBTITER) / PFIZER/WYETH M125HF / 2 3 LL / -

Administered by: Public      Purchased by: Public
Symptoms: 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: runny nose past 3 days
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CXR, Blood test
CDC 'Split Type': HI9207

Write-up: Pt devel t102 fever aobut 5PM on day of immun which continued throughout next 48 hrs inspite of APAP, liquids, & frequent warm showers; Seen by MD 19DEC91 fever continued elevating to 104.8 & revisited MD; exam by MD 20DEC91 CXR & lab work;


Changed on 2/14/2018

VAERS ID: 39747 Before After
VAERS Form:1
Age:0.5
Sex:Female
Location:Hawaii
Vaccinated:1991-12-17
Onset:1991-12-17
Submitted:1991-12-23
Entered:1992-03-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 304922 / 3 RL / -
HEP: HEP B (FOREIGN) / MERCK & CO. INC. 0169T / 2 LL / -
HIBV: HIB (HIBTITER) / PFIZER/WYETH M125HF / 3 LL / -

Administered by: Public      Purchased by: Public
Symptoms: 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: runny nose past 3 days
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CXR, Blood test
CDC 'Split Type': HI9207

Write-up: Pt devel t102 fever aobut 5PM on day of immun which continued throughout next 48 hrs inspite of APAP, liquids, & frequent warm showers; Seen by MD 19DEC91 fever continued elevating to 104.8 & revisited MD; exam by MD 20DEC91 CXR & lab work;


Changed on 6/14/2018

VAERS ID: 39747 Before After
VAERS Form:1
Age:0.5
Sex:Female
Location:Hawaii
Vaccinated:1991-12-17
Onset:1991-12-17
Submitted:1991-12-23
Entered:1992-03-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 304922 / 3 RL / -
HEP: HEP B (FOREIGN) / MERCK & CO. INC. 0169T / 2 LL / -
HIBV: HIB (HIBTITER) / PFIZER/WYETH M125HF / 3 LL / -

Administered by: Public      Purchased by: Public
Symptoms: 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: runny nose past 3 days
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CXR, Blood test
CDC 'Split Type': HI9207

Write-up: Pt devel t102 fever aobut 5PM on day of immun which continued throughout next 48 hrs inspite of APAP, liquids, & frequent warm showers; Seen by MD 19DEC91 fever continued elevating to 104.8 & revisited MD; exam by MD 20DEC91 CXR & lab work;


Changed on 8/14/2018

VAERS ID: 39747 Before After
VAERS Form:1
Age:0.5
Sex:Female
Location:Hawaii
Vaccinated:1991-12-17
Onset:1991-12-17
Submitted:1991-12-23
Entered:1992-03-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 304922 / 3 RL / -
HEP: HEP B (FOREIGN) / MERCK & CO. INC. 0169T / 2 LL / -
HIBV: HIB (HIBTITER) / PFIZER/WYETH M125HF / 3 LL / -

Administered by: Public      Purchased by: Public
Symptoms: 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: runny nose past 3 days
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CXR, Blood test
CDC 'Split Type': HI9207

Write-up: Pt devel t102 fever aobut 5PM on day of immun which continued throughout next 48 hrs inspite of APAP, liquids, & frequent warm showers; Seen by MD 19DEC91 fever continued elevating to 104.8 & revisited MD; exam by MD 20DEC91 CXR & lab work;


Changed on 9/14/2018

VAERS ID: 39747 Before After
VAERS Form:1
Age:0.5
Sex:Female
Location:Hawaii
Vaccinated:1991-12-17
Onset:1991-12-17
Submitted:1991-12-23
Entered:1992-03-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 304922 / 3 RL / -
HEP: HEP B (FOREIGN) / MERCK & CO. INC. 0169T / 2 LL / -
HIBV: HIB (HIBTITER) / PFIZER/WYETH M125HF / 3 LL / -

Administered by: Public      Purchased by: Public
Symptoms: 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: runny nose past 3 days
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CXR, Blood test
CDC 'Split Type': HI9207

Write-up: Pt devel t102 fever aobut 5PM on day of immun which continued throughout next 48 hrs inspite of APAP, liquids, & frequent warm showers; Seen by MD 19DEC91 fever continued elevating to 104.8 & revisited MD; exam by MD 20DEC91 CXR & lab work;


Changed on 10/14/2018

VAERS ID: 39747 Before After
VAERS Form:1
Age:0.5
Sex:Female
Location:Hawaii
Vaccinated:1991-12-17
Onset:1991-12-17
Submitted:1991-12-23
Entered:1992-03-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 304922 / 3 RL / -
HEP: HEP B (FOREIGN) / MERCK & CO. INC. 0169T / 2 LL / -
HIBV: HIB (HIBTITER) / PFIZER/WYETH M125HF / 3 LL / -

Administered by: Public      Purchased by: Public
Symptoms: 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: runny nose past 3 days
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CXR, Blood test
CDC 'Split Type': HI9207

Write-up: Pt devel t102 fever aobut 5PM on day of immun which continued throughout next 48 hrs inspite of APAP, liquids, & frequent warm showers; Seen by MD 19DEC91 fever continued elevating to 104.8 & revisited MD; exam by MD 20DEC91 CXR & lab work;

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