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This is VAERS ID 41777

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 41777
VAERS Form:
Age:0.2
Sex:Male
Location:Hawaii
Vaccinated:1992-05-01
Onset:1992-05-01
Submitted:1992-05-01
Entered:1992-05-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP / CONNAUGHT LABS 2G31010 / 0 LL / IM
HEP: RECOMBIVAX HB / MSD 0310V / 0 RL / IM
HIBV: HIBTITER / LEDERLE(PRAXIS) M155HN / 0 RL / IM
OPV: ORIMUNE / LEDERLE 647F / 0 - / PO

Administered by: Private      Purchased by: Unknown
Symptoms: AGITATION, FEVER, DYSPNEA

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: NA
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': NONE

Write-up: Unusual breathing pattern; unusual fussiness; fever;


Changed on 12/8/2009

VAERS ID: 41777 Before After
VAERS Form:
Age:0.2
Sex:Male
Location:Hawaii
Vaccinated:1992-05-01
Onset:1992-05-01
Submitted:1992-05-01
Entered:1992-05-11 1992-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP DTP (NO BRAND NAME) / CONNAUGHT LABS CONNAUGHT LABORATORIES 2G31010 / 0 LL / IM
HEP: RECOMBIVAX HB HEP B (RECOMBIVAX HB) / MSD MERCK & CO. INC. 0310V / 0 RL / IM
HIBV: HIBTITER HIB (HIBTITER) / LEDERLE(PRAXIS) LEDERLE PRAXSIS M155HN / 0 RL / IM
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES 647F / 0 - / PO

Administered by: Private      Purchased by: Unknown Private
Symptoms: Agitation, Dyspnoea, Pyrexia, AGITATION, FEVER, DYSPNEA

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: NA
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': NONE (blank)

Write-up: Unusual breathing pattern; unusual fussiness; fever;


Changed on 5/14/2017

VAERS ID: 41777 Before After
VAERS Form:
Age:0.2
Sex:Male
Location:Hawaii
Vaccinated:1992-05-01
Onset:1992-05-01
Submitted:1992-05-01
Entered:1992-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 2G31010 / 0 LL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0310V / 0 RL / IM
HIBV: HIB (HIBTITER) / LEDERLE PRAXSIS PFIZER/WYETH M155HN / 0 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 647F / 0 - / PO

Administered by: Private      Purchased by: Private
Symptoms: Agitation, Dyspnoea, 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: NA NA~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Unusual breathing pattern; unusual fussiness; fever;


Changed on 9/14/2017

VAERS ID: 41777 Before After
VAERS Form:(blank) 1
Age:0.2
Sex:Male
Location:Hawaii
Vaccinated:1992-05-01
Onset:1992-05-01
Submitted:1992-05-01
Entered:1992-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 2G31010 / 0 1 LL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0310V / 0 1 RL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M155HN / 0 1 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 647F / 0 1 - MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Agitation, Dyspnoea, 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: NA~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Unusual breathing pattern; unusual fussiness; fever;


Changed on 2/14/2018

VAERS ID: 41777 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Hawaii
Vaccinated:1992-05-01
Onset:1992-05-01
Submitted:1992-05-01
Entered:1992-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 2G31010 / 1 LL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0310V / 1 RL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M155HN / 1 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 647F / 1 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Agitation, Dyspnoea, 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: NA~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Unusual breathing pattern; unusual fussiness; fever;


Changed on 6/14/2018

VAERS ID: 41777 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Hawaii
Vaccinated:1992-05-01
Onset:1992-05-01
Submitted:1992-05-01
Entered:1992-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 2G31010 / 1 LL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0310V / 1 RL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M155HN / 1 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 647F / 1 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Agitation, Dyspnoea, 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: NA~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Unusual breathing pattern; unusual fussiness; fever;


Changed on 8/14/2018

VAERS ID: 41777 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Hawaii
Vaccinated:1992-05-01
Onset:1992-05-01
Submitted:1992-05-01
Entered:1992-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 2G31010 / 1 LL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0310V / 1 RL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M155HN / 1 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 647F / 1 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Agitation, Dyspnoea, 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: NA~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Unusual breathing pattern; unusual fussiness; fever;


Changed on 9/14/2018

VAERS ID: 41777 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Hawaii
Vaccinated:1992-05-01
Onset:1992-05-01
Submitted:1992-05-01
Entered:1992-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 2G31010 / 1 LL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0310V / 1 RL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M155HN / 1 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 647F / 1 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Agitation, Dyspnoea, 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: NA~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Unusual breathing pattern; unusual fussiness; fever;


Changed on 10/14/2018

VAERS ID: 41777 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Hawaii
Vaccinated:1992-05-01
Onset:1992-05-01
Submitted:1992-05-01
Entered:1992-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 2G31010 / 1 LL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0310V / 1 RL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M155HN / 1 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 647F / 1 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Agitation, Dyspnoea, 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: NA~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Unusual breathing pattern; unusual fussiness; fever;

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=41777&WAYBACKHISTORY=ON


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