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This is VAERS ID 40391

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 40391
VAERS Form:
Age:0.6
Sex:Male
Location:Mississippi
Vaccinated:1992-02-20
Onset:1992-02-20
Submitted:1992-03-10
Entered:1992-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 304924 / 1 RL / -
HEP: HEPTAVAX / MSD 1294T / 2 LL / -
HIBV: HIBTITER / LEDERLE(PRAXIS) M155HJ / 1 LL / -
OPV: ORIMUNE / LEDERLE 304925 / 1 - / PO

Administered by: Public      Purchased by: Unknown
Symptoms: FEVER, RASH

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? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: well child imporved from ear infect
Preexisting Conditions: pt had cold, ear infect;
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': pt had cold, ear infect;

Write-up: Mom states pt had fine red rash across face/trunk/inc temp x 2-3 days; Onset 24FEB-27FEB92 rash; Onset inc temp 20FEB - 24FEB92;


Changed on 12/8/2009

VAERS ID: 40391 Before After
VAERS Form:
Age:0.6
Sex:Male
Location:Mississippi
Vaccinated:1992-02-20
Onset:1992-02-20
Submitted:1992-03-10
Entered:1992-03-26 1992-03-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL DTP (TRI-IMMUNOL) / LEDERLE LEDERLE LABORATORIES 304924 / 1 RL / -
HEP: HEPTAVAX HEP B (HEPTAVAX) / MSD MERCK & CO. INC. 1294T / 2 LL / -
HIBV: HIBTITER HIB (HIBTITER) / LEDERLE(PRAXIS) LEDERLE PRAXSIS M155HJ / 1 LL / -
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES 304925 / 1 - / PO

Administered by: Public      Purchased by: Unknown Public
Symptoms: Pyrexia, Rash, FEVER, RASH

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? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: well child imporved from ear infect
Preexisting Conditions: pt had cold, ear infect;
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': pt had cold, ear infect; MS9205

Write-up: Mom states pt had fine red rash across face/trunk/inc temp x 2-3 days; Onset 24FEB-27FEB92 rash; Onset inc temp 20FEB - 24FEB92;


Changed on 8/31/2010

VAERS ID: 40391 Before After
VAERS Form:
Age:0.6
Sex:Male
Location:Mississippi
Vaccinated:1992-02-20
Onset:1992-02-20
Submitted:1992-03-10
Entered:1992-03-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 304924 / 1 RL / -
HEP: HEP B (HEPTAVAX) HEP B (FOREIGN) / MERCK & CO. INC. 1294T / 2 LL / -
HIBV: HIB (HIBTITER) / LEDERLE PRAXSIS M155HJ / 1 LL / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES 304925 / 1 - / PO

Administered by: Public      Purchased by: Public
Symptoms: Pyrexia, Rash

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? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: well child imporved from ear infect
Preexisting Conditions: pt had cold, ear infect;
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': MS9205

Write-up: Mom states pt had fine red rash across face/trunk/inc temp x 2-3 days; Onset 24FEB-27FEB92 rash; Onset inc temp 20FEB - 24FEB92;


Changed on 5/14/2017

VAERS ID: 40391 Before After
VAERS Form:
Age:0.6
Sex:Male
Location:Mississippi
Vaccinated:1992-02-20
Onset:1992-02-20
Submitted:1992-03-10
Entered:1992-03-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 304924 / 1 RL / -
HEP: HEP B (FOREIGN) / MERCK & CO. INC. 1294T / 2 LL / -
HIBV: HIB (HIBTITER) / LEDERLE PRAXSIS PFIZER/WYETH M155HJ / 1 LL / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 304925 / 1 - / PO

Administered by: Public      Purchased by: Public
Symptoms: Pyrexia, Rash

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? No
Previous Vaccinations: NONE NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: well child imporved from ear infect
Preexisting Conditions: pt had cold, ear infect;
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': MS9205

Write-up: Mom states pt had fine red rash across face/trunk/inc temp x 2-3 days; Onset 24FEB-27FEB92 rash; Onset inc temp 20FEB - 24FEB92;


Changed on 9/14/2017

VAERS ID: 40391 Before After
VAERS Form:(blank) 1
Age:0.6
Sex:Male
Location:Mississippi
Vaccinated:1992-02-20
Onset:1992-02-20
Submitted:1992-03-10
Entered:1992-03-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 304924 / 1 2 RL / -
HEP: HEP B (FOREIGN) / MERCK & CO. INC. 1294T / 2 3 LL / -
HIBV: HIB (HIBTITER) / PFIZER/WYETH M155HJ / 1 2 LL / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 304925 / 1 2 - MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Pyrexia, Rash

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? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: well child imporved from ear infect
Preexisting Conditions: pt had cold, ear infect;
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': MS9205

Write-up: Mom states pt had fine red rash across face/trunk/inc temp x 2-3 days; Onset 24FEB-27FEB92 rash; Onset inc temp 20FEB - 24FEB92;


Changed on 2/14/2018

VAERS ID: 40391 Before After
VAERS Form:1
Age:0.6
Sex:Male
Location:Mississippi
Vaccinated:1992-02-20
Onset:1992-02-20
Submitted:1992-03-10
Entered:1992-03-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 304924 / 2 RL / -
HEP: HEP B (FOREIGN) / MERCK & CO. INC. 1294T / 3 LL / -
HIBV: HIB (HIBTITER) / PFIZER/WYETH M155HJ / 2 LL / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 304925 / 2 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Pyrexia, Rash

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? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: well child imporved from ear infect
Preexisting Conditions: pt had cold, ear infect;
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': MS9205

Write-up: Mom states pt had fine red rash across face/trunk/inc temp x 2-3 days; Onset 24FEB-27FEB92 rash; Onset inc temp 20FEB - 24FEB92;


Changed on 6/14/2018

VAERS ID: 40391 Before After
VAERS Form:1
Age:0.6
Sex:Male
Location:Mississippi
Vaccinated:1992-02-20
Onset:1992-02-20
Submitted:1992-03-10
Entered:1992-03-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 304924 / 2 RL / -
HEP: HEP B (FOREIGN) / MERCK & CO. INC. 1294T / 3 LL / -
HIBV: HIB (HIBTITER) / PFIZER/WYETH M155HJ / 2 LL / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 304925 / 2 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Pyrexia, Rash

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? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: well child imporved from ear infect
Preexisting Conditions: pt had cold, ear infect;
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': MS9205

Write-up: Mom states pt had fine red rash across face/trunk/inc temp x 2-3 days; Onset 24FEB-27FEB92 rash; Onset inc temp 20FEB - 24FEB92;


Changed on 8/14/2018

VAERS ID: 40391 Before After
VAERS Form:1
Age:0.6
Sex:Male
Location:Mississippi
Vaccinated:1992-02-20
Onset:1992-02-20
Submitted:1992-03-10
Entered:1992-03-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 304924 / 2 RL / -
HEP: HEP B (FOREIGN) / MERCK & CO. INC. 1294T / 3 LL / -
HIBV: HIB (HIBTITER) / PFIZER/WYETH M155HJ / 2 LL / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 304925 / 2 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Pyrexia, Rash

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? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: well child imporved from ear infect
Preexisting Conditions: pt had cold, ear infect;
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': MS9205

Write-up: Mom states pt had fine red rash across face/trunk/inc temp x 2-3 days; Onset 24FEB-27FEB92 rash; Onset inc temp 20FEB - 24FEB92;


Changed on 9/14/2018

VAERS ID: 40391 Before After
VAERS Form:1
Age:0.6
Sex:Male
Location:Mississippi
Vaccinated:1992-02-20
Onset:1992-02-20
Submitted:1992-03-10
Entered:1992-03-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 304924 / 2 RL / -
HEP: HEP B (FOREIGN) / MERCK & CO. INC. 1294T / 3 LL / -
HIBV: HIB (HIBTITER) / PFIZER/WYETH M155HJ / 2 LL / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 304925 / 2 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Pyrexia, Rash

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? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: well child imporved from ear infect
Preexisting Conditions: pt had cold, ear infect;
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': MS9205

Write-up: Mom states pt had fine red rash across face/trunk/inc temp x 2-3 days; Onset 24FEB-27FEB92 rash; Onset inc temp 20FEB - 24FEB92;


Changed on 10/14/2018

VAERS ID: 40391 Before After
VAERS Form:1
Age:0.6
Sex:Male
Location:Mississippi
Vaccinated:1992-02-20
Onset:1992-02-20
Submitted:1992-03-10
Entered:1992-03-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 304924 / 2 RL / -
HEP: HEP B (FOREIGN) / MERCK & CO. INC. 1294T / 3 LL / -
HIBV: HIB (HIBTITER) / PFIZER/WYETH M155HJ / 2 LL / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 304925 / 2 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Pyrexia, Rash

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? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: well child imporved from ear infect
Preexisting Conditions: pt had cold, ear infect;
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': MS9205

Write-up: Mom states pt had fine red rash across face/trunk/inc temp x 2-3 days; Onset 24FEB-27FEB92 rash; Onset inc temp 20FEB - 24FEB92;

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=40391&WAYBACKHISTORY=ON


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