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This is VAERS ID 42453

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 42453
VAERS Form:
Age:1.7
Sex:Male
Location:Kansas
Vaccinated:1992-04-06
Onset:0000-00-00
Submitted:1992-05-18
Entered:1992-06-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 314958 / 2 LL / IM
MMR: MMR II / MSD 1483T / 0 RA / SC
OPV: ORIMUNE / LEDERLE 312925 / 2 - / PO

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: eval for muscle-disease;
Preexisting Conditions: pt has carnitine deficiency; pt deaf from birth;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Fever, sz;


Changed on 12/8/2009

VAERS ID: 42453 Before After
VAERS Form:
Age:1.7
Sex:Male
Location:Kansas
Vaccinated:1992-04-06
Onset:0000-00-00
Submitted:1992-05-18
Entered:1992-06-05 1992-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL DTP (TRI-IMMUNOL) / LEDERLE LEDERLE LABORATORIES 314958 / 2 LL / IM
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 1483T / 0 RA / SC
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES 312925 / 2 - / PO

Administered by: Public      Purchased by: Unknown
Symptoms: Convulsion, Pyrexia, CONVULS, FEVER

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: eval for muscle-disease;
Preexisting Conditions: pt has carnitine deficiency; pt deaf from birth;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) KS92028

Write-up: Fever, sz;


Changed on 5/14/2017

VAERS ID: 42453 Before After
VAERS Form:
Age:1.7
Sex:Male
Location:Kansas
Vaccinated:1992-04-06
Onset:0000-00-00
Submitted:1992-05-18
Entered:1992-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 314958 / 2 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1483T / 0 RA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 312925 / 2 - / PO

Administered by: Public      Purchased by: Unknown
Symptoms: Convulsion, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: eval for muscle-disease;
Preexisting Conditions: pt has carnitine deficiency; pt deaf from birth;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': KS92028

Write-up: Fever, sz;


Changed on 9/14/2017

VAERS ID: 42453 Before After
VAERS Form:(blank) 1
Age:1.7
Sex:Male
Location:Kansas
Vaccinated:1992-04-06
Onset:0000-00-00
Submitted:1992-05-18
Entered:1992-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 314958 / 2 3 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1483T / 0 1 RA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 312925 / 2 3 - MO / PO

Administered by: Public      Purchased by: Unknown
Symptoms: Convulsion, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: eval for muscle-disease;
Preexisting Conditions: pt has carnitine deficiency; pt deaf from birth;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': KS92028

Write-up: Fever, sz;


Changed on 2/14/2018

VAERS ID: 42453 Before After
VAERS Form:1
Age:1.7
Sex:Male
Location:Kansas
Vaccinated:1992-04-06
Onset:0000-00-00
Submitted:1992-05-18
Entered:1992-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 314958 / 3 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1483T / 1 RA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 312925 / 3 MO / PO

Administered by: Public      Purchased by: Unknown
Symptoms: Convulsion, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: eval for muscle-disease;
Preexisting Conditions: pt has carnitine deficiency; pt deaf from birth;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': KS92028

Write-up: Fever, sz;


Changed on 6/14/2018

VAERS ID: 42453 Before After
VAERS Form:1
Age:1.7
Sex:Male
Location:Kansas
Vaccinated:1992-04-06
Onset:0000-00-00
Submitted:1992-05-18
Entered:1992-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 314958 / 3 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1483T / 1 RA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 312925 / 3 MO / PO

Administered by: Public      Purchased by: Unknown
Symptoms: Convulsion, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: eval for muscle-disease;
Preexisting Conditions: pt has carnitine deficiency; pt deaf from birth;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': KS92028

Write-up: Fever, sz;


Changed on 8/14/2018

VAERS ID: 42453 Before After
VAERS Form:1
Age:1.7
Sex:Male
Location:Kansas
Vaccinated:1992-04-06
Onset:0000-00-00
Submitted:1992-05-18
Entered:1992-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 314958 / 3 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1483T / 1 RA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 312925 / 3 MO / PO

Administered by: Public      Purchased by: Unknown
Symptoms: Convulsion, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: eval for muscle-disease;
Preexisting Conditions: pt has carnitine deficiency; pt deaf from birth;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': KS92028

Write-up: Fever, sz;


Changed on 9/14/2018

VAERS ID: 42453 Before After
VAERS Form:1
Age:1.7
Sex:Male
Location:Kansas
Vaccinated:1992-04-06
Onset:0000-00-00
Submitted:1992-05-18
Entered:1992-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 314958 / 3 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1483T / 1 RA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 312925 / 3 MO / PO

Administered by: Public      Purchased by: Unknown
Symptoms: Convulsion, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: eval for muscle-disease;
Preexisting Conditions: pt has carnitine deficiency; pt deaf from birth;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': KS92028

Write-up: Fever, sz;


Changed on 10/14/2018

VAERS ID: 42453 Before After
VAERS Form:1
Age:1.7
Sex:Male
Location:Kansas
Vaccinated:1992-04-06
Onset:0000-00-00
Submitted:1992-05-18
Entered:1992-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 314958 / 3 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1483T / 1 RA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 312925 / 3 MO / PO

Administered by: Public      Purchased by: Unknown
Symptoms: Convulsion, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: eval for muscle-disease;
Preexisting Conditions: pt has carnitine deficiency; pt deaf from birth;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': KS92028

Write-up: Fever, sz;

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