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This is VAERS ID 42459

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 42459
VAERS Form:
Age:0.8
Sex:Male
Location:Ohio
Vaccinated:1992-05-20
Onset:1992-05-22
Submitted:1992-05-29
Entered:1992-06-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 316975 / 1 RL / IM
HEP: HEPTAVAX / MSD 0230V / 0 RL / IM
HIBV: HIBTITER / LEDERLE(PRAXIS) M695HK / 1 LL / IM
OPV: ORIMUNE / LEDERLE 64502 / 1 - / PO

Administered by: Private      Purchased by: Unknown
Symptoms: CONVULS, EYES GAZE UPWARD, TWITCH

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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: pt exp sz @ 8mos w/1st DTP/HIB/OPV #1 dose;
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: all neg;
CDC 'Split Type': NONE

Write-up: Pt recvd vax 20MAY92 & on 22MAY had tonic clonic generalized seizure, eyes rolling & twitching; pt now on Phenobarb;


Changed on 12/8/2009

VAERS ID: 42459 Before After
VAERS Form:
Age:0.8
Sex:Male
Location:Ohio
Vaccinated:1992-05-20
Onset:1992-05-22
Submitted:1992-05-29
Entered:1992-06-05 1992-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL DTP (TRI-IMMUNOL) / LEDERLE LEDERLE LABORATORIES 316975 / 1 RL / IM
HEP: HEPTAVAX HEP B (HEPTAVAX) / MSD MERCK & CO. INC. 0230V / 0 RL / IM
HIBV: HIBTITER HIB (HIBTITER) / LEDERLE(PRAXIS) LEDERLE PRAXSIS M695HK / 1 LL / IM
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES 64502 / 1 - / PO

Administered by: Private      Purchased by: Unknown Public
Symptoms: Convulsion, Muscle twitching, Gaze palsy, CONVULS, EYES GAZE UPWARD, TWITCH

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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: pt exp sz @ 8mos w/1st DTP/HIB/OPV #1 dose;
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: all neg;
CDC 'Split Type': NONE (blank)

Write-up: Pt recvd vax 20MAY92 & on 22MAY had tonic clonic generalized seizure, eyes rolling & twitching; pt now on Phenobarb;


Changed on 8/31/2010

VAERS ID: 42459 Before After
VAERS Form:
Age:0.8
Sex:Male
Location:Ohio
Vaccinated:1992-05-20
Onset:1992-05-22
Submitted:1992-05-29
Entered:1992-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 316975 / 1 RL / IM
HEP: HEP B (HEPTAVAX) HEP B (FOREIGN) / MERCK & CO. INC. 0230V / 0 RL / IM
HIBV: HIB (HIBTITER) / LEDERLE PRAXSIS M695HK / 1 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES 64502 / 1 - / PO

Administered by: Private      Purchased by: Public
Symptoms: Convulsion, Muscle twitching, Gaze palsy

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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: pt exp sz @ 8mos w/1st DTP/HIB/OPV #1 dose;
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: all neg;
CDC 'Split Type':

Write-up: Pt recvd vax 20MAY92 & on 22MAY had tonic clonic generalized seizure, eyes rolling & twitching; pt now on Phenobarb;


Changed on 5/14/2017

VAERS ID: 42459 Before After
VAERS Form:
Age:0.8
Sex:Male
Location:Ohio
Vaccinated:1992-05-20
Onset:1992-05-22
Submitted:1992-05-29
Entered:1992-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 316975 / 1 RL / IM
HEP: HEP B (FOREIGN) / MERCK & CO. INC. 0230V / 0 RL / IM
HIBV: HIB (HIBTITER) / LEDERLE PRAXSIS PFIZER/WYETH M695HK / 1 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 64502 / 1 - / PO

Administered by: Private      Purchased by: Public
Symptoms: Convulsion, Muscle twitching, Gaze palsy

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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: pt exp sz @ 8mos w/1st DTP/HIB/OPV #1 dose; dose;~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: all neg;
CDC 'Split Type':

Write-up: Pt recvd vax 20MAY92 & on 22MAY had tonic clonic generalized seizure, eyes rolling & twitching; pt now on Phenobarb;


Changed on 9/14/2017

VAERS ID: 42459 Before After
VAERS Form:(blank) 1
Age:0.8
Sex:Male
Location:Ohio
Vaccinated:1992-05-20
Onset:1992-05-22
Submitted:1992-05-29
Entered:1992-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 316975 / 1 2 RL / IM
HEP: HEP B (FOREIGN) / MERCK & CO. INC. 0230V / 0 1 RL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M695HK / 1 2 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 64502 / 1 2 - MO / PO

Administered by: Private      Purchased by: Public
Symptoms: Convulsion, Muscle twitching, Gaze palsy

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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: pt exp sz @ 8mos w/1st DTP/HIB/OPV #1 dose;~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: all neg;
CDC 'Split Type':

Write-up: Pt recvd vax 20MAY92 & on 22MAY had tonic clonic generalized seizure, eyes rolling & twitching; pt now on Phenobarb;


Changed on 2/14/2018

VAERS ID: 42459 Before After
VAERS Form:1
Age:0.8
Sex:Male
Location:Ohio
Vaccinated:1992-05-20
Onset:1992-05-22
Submitted:1992-05-29
Entered:1992-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 316975 / 2 RL / IM
HEP: HEP B (FOREIGN) / MERCK & CO. INC. 0230V / 1 RL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M695HK / 2 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 64502 / 2 MO / PO

Administered by: Private      Purchased by: Public
Symptoms: Convulsion, Muscle twitching, Gaze palsy

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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: pt exp sz @ 8mos w/1st DTP/HIB/OPV #1 dose;~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: all neg;
CDC 'Split Type':

Write-up: Pt recvd vax 20MAY92 & on 22MAY had tonic clonic generalized seizure, eyes rolling & twitching; pt now on Phenobarb;


Changed on 6/14/2018

VAERS ID: 42459 Before After
VAERS Form:1
Age:0.8
Sex:Male
Location:Ohio
Vaccinated:1992-05-20
Onset:1992-05-22
Submitted:1992-05-29
Entered:1992-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 316975 / 2 RL / IM
HEP: HEP B (FOREIGN) / MERCK & CO. INC. 0230V / 1 RL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M695HK / 2 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 64502 / 2 MO / PO

Administered by: Private      Purchased by: Public
Symptoms: Convulsion, Muscle twitching, Gaze palsy

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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: pt exp sz @ 8mos w/1st DTP/HIB/OPV #1 dose;~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: all neg;
CDC 'Split Type':

Write-up: Pt recvd vax 20MAY92 & on 22MAY had tonic clonic generalized seizure, eyes rolling & twitching; pt now on Phenobarb;


Changed on 8/14/2018

VAERS ID: 42459 Before After
VAERS Form:1
Age:0.8
Sex:Male
Location:Ohio
Vaccinated:1992-05-20
Onset:1992-05-22
Submitted:1992-05-29
Entered:1992-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 316975 / 2 RL / IM
HEP: HEP B (FOREIGN) / MERCK & CO. INC. 0230V / 1 RL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M695HK / 2 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 64502 / 2 MO / PO

Administered by: Private      Purchased by: Public
Symptoms: Convulsion, Muscle twitching, Gaze palsy

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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: pt exp sz @ 8mos w/1st DTP/HIB/OPV #1 dose;~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: all neg;
CDC 'Split Type':

Write-up: Pt recvd vax 20MAY92 & on 22MAY had tonic clonic generalized seizure, eyes rolling & twitching; pt now on Phenobarb;


Changed on 9/14/2018

VAERS ID: 42459 Before After
VAERS Form:1
Age:0.8
Sex:Male
Location:Ohio
Vaccinated:1992-05-20
Onset:1992-05-22
Submitted:1992-05-29
Entered:1992-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 316975 / 2 RL / IM
HEP: HEP B (FOREIGN) / MERCK & CO. INC. 0230V / 1 RL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M695HK / 2 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 64502 / 2 MO / PO

Administered by: Private      Purchased by: Public
Symptoms: Convulsion, Muscle twitching, Gaze palsy

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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: pt exp sz @ 8mos w/1st DTP/HIB/OPV #1 dose;~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: all neg;
CDC 'Split Type':

Write-up: Pt recvd vax 20MAY92 & on 22MAY had tonic clonic generalized seizure, eyes rolling & twitching; pt now on Phenobarb;


Changed on 10/14/2018

VAERS ID: 42459 Before After
VAERS Form:1
Age:0.8
Sex:Male
Location:Ohio
Vaccinated:1992-05-20
Onset:1992-05-22
Submitted:1992-05-29
Entered:1992-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 316975 / 2 RL / IM
HEP: HEP B (FOREIGN) / MERCK & CO. INC. 0230V / 1 RL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M695HK / 2 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 64502 / 2 MO / PO

Administered by: Private      Purchased by: Public
Symptoms: Convulsion, Muscle twitching, Gaze palsy

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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: pt exp sz @ 8mos w/1st DTP/HIB/OPV #1 dose;~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: all neg;
CDC 'Split Type':

Write-up: Pt recvd vax 20MAY92 & on 22MAY had tonic clonic generalized seizure, eyes rolling & twitching; pt now on Phenobarb;

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