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This is VAERS ID 42838

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 42838
VAERS Form:
Age:1.4
Sex:Female
Location:Utah
Vaccinated:1992-03-16
Onset:1992-03-16
Submitted:1992-03-17
Entered:1992-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 314960 / 3 LL / IM
HIBV: HIBTITER / LEDERLE(PRAXIS) M160HH / 3 RL / IM
MMR: MMR II / MSD 1714S / 0 RA / SC
OPV: ORIMUNE / LEDERLE 312918 / 2 - / PO

Administered by: Public      Purchased by: Unknown
Symptoms: DYSPNEA, LEUKOCYTOSIS, PNEUMONIA

Life Threatening? Yes
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? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: asthma
Allergies:
Diagnostic Lab Data: 17MAR92 6AM WBC 32,000;
CDC 'Split Type':

Write-up: 16MAR92 pt recvd DTP/OPV/MMR/HIB a/noon; 8PM pt was exp difficulty breathing; had a prev dx of asthma, taken to local ER; not responding to tx for astham; later life-flighted to hosp x 3 days; 17MAR92 WBC 32,000; dx pneumonia;


Changed on 12/8/2009

VAERS ID: 42838 Before After
VAERS Form:
Age:1.4
Sex:Female
Location:Utah
Vaccinated:1992-03-16
Onset:1992-03-16
Submitted:1992-03-17
Entered:1992-06-19 1992-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL DTP (TRI-IMMUNOL) / LEDERLE LEDERLE LABORATORIES 314960 / 3 LL / IM
HIBV: HIBTITER HIB (HIBTITER) / LEDERLE(PRAXIS) LEDERLE PRAXSIS M160HH / 3 RL / IM
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 1714S / 0 RA / SC
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES 312918 / 2 - / PO

Administered by: Public      Purchased by: Unknown Public
Symptoms: Dyspnoea, Leukocytosis, Pneumonia, DYSPNEA, LEUKOCYTOSIS, PNEUMONIA

Life Threatening? Yes
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? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: asthma
Allergies:
Diagnostic Lab Data: 17MAR92 6AM WBC 32,000;
CDC 'Split Type': (blank) UT920013

Write-up: 16MAR92 pt recvd DTP/OPV/MMR/HIB a/noon; 8PM pt was exp difficulty breathing; had a prev dx of asthma, taken to local ER; not responding to tx for astham; later life-flighted to hosp x 3 days; 17MAR92 WBC 32,000; dx pneumonia;


Changed on 5/14/2017

VAERS ID: 42838 Before After
VAERS Form:
Age:1.4
Sex:Female
Location:Utah
Vaccinated:1992-03-16
Onset:1992-03-16
Submitted:1992-03-17
Entered:1992-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 314960 / 3 LL / IM
HIBV: HIB (HIBTITER) / LEDERLE PRAXSIS PFIZER/WYETH M160HH / 3 RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1714S / 0 RA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 312918 / 2 - / PO

Administered by: Public      Purchased by: Public
Symptoms: Dyspnoea, Leukocytosis, Pneumonia

Life Threatening? Yes
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? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: asthma
Allergies:
Diagnostic Lab Data: 17MAR92 6AM WBC 32,000;
CDC 'Split Type': UT920013

Write-up: 16MAR92 pt recvd DTP/OPV/MMR/HIB a/noon; 8PM pt was exp difficulty breathing; had a prev dx of asthma, taken to local ER; not responding to tx for astham; later life-flighted to hosp x 3 days; 17MAR92 WBC 32,000; dx pneumonia;


Changed on 9/14/2017

VAERS ID: 42838 Before After
VAERS Form:(blank) 1
Age:1.4
Sex:Female
Location:Utah
Vaccinated:1992-03-16
Onset:1992-03-16
Submitted:1992-03-17
Entered:1992-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 314960 / 3 4 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M160HH / 3 4 RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1714S / 0 1 RA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 312918 / 2 3 - MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Dyspnoea, Leukocytosis, Pneumonia

Life Threatening? Yes
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? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: asthma
Allergies:
Diagnostic Lab Data: 17MAR92 6AM WBC 32,000;
CDC 'Split Type': UT920013

Write-up: 16MAR92 pt recvd DTP/OPV/MMR/HIB a/noon; 8PM pt was exp difficulty breathing; had a prev dx of asthma, taken to local ER; not responding to tx for astham; later life-flighted to hosp x 3 days; 17MAR92 WBC 32,000; dx pneumonia;


Changed on 2/14/2018

VAERS ID: 42838 Before After
VAERS Form:1
Age:1.4
Sex:Female
Location:Utah
Vaccinated:1992-03-16
Onset:1992-03-16
Submitted:1992-03-17
Entered:1992-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 314960 / 4 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M160HH / 4 RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1714S / 1 RA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 312918 / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Dyspnoea, Leukocytosis, Pneumonia

Life Threatening? Yes
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? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: asthma
Allergies:
Diagnostic Lab Data: 17MAR92 6AM WBC 32,000;
CDC 'Split Type': UT920013

Write-up: 16MAR92 pt recvd DTP/OPV/MMR/HIB a/noon; 8PM pt was exp difficulty breathing; had a prev dx of asthma, taken to local ER; not responding to tx for astham; later life-flighted to hosp x 3 days; 17MAR92 WBC 32,000; dx pneumonia;


Changed on 6/14/2018

VAERS ID: 42838 Before After
VAERS Form:1
Age:1.4
Sex:Female
Location:Utah
Vaccinated:1992-03-16
Onset:1992-03-16
Submitted:1992-03-17
Entered:1992-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 314960 / 4 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M160HH / 4 RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1714S / 1 RA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 312918 / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Dyspnoea, Leukocytosis, Pneumonia

Life Threatening? Yes
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? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: asthma
Allergies:
Diagnostic Lab Data: 17MAR92 6AM WBC 32,000;
CDC 'Split Type': UT920013

Write-up: 16MAR92 pt recvd DTP/OPV/MMR/HIB a/noon; 8PM pt was exp difficulty breathing; had a prev dx of asthma, taken to local ER; not responding to tx for astham; later life-flighted to hosp x 3 days; 17MAR92 WBC 32,000; dx pneumonia;


Changed on 8/14/2018

VAERS ID: 42838 Before After
VAERS Form:1
Age:1.4
Sex:Female
Location:Utah
Vaccinated:1992-03-16
Onset:1992-03-16
Submitted:1992-03-17
Entered:1992-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 314960 / 4 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M160HH / 4 RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1714S / 1 RA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 312918 / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Dyspnoea, Leukocytosis, Pneumonia

Life Threatening? Yes
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? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: asthma
Allergies:
Diagnostic Lab Data: 17MAR92 6AM WBC 32,000;
CDC 'Split Type': UT920013

Write-up: 16MAR92 pt recvd DTP/OPV/MMR/HIB a/noon; 8PM pt was exp difficulty breathing; had a prev dx of asthma, taken to local ER; not responding to tx for astham; later life-flighted to hosp x 3 days; 17MAR92 WBC 32,000; dx pneumonia;


Changed on 9/14/2018

VAERS ID: 42838 Before After
VAERS Form:1
Age:1.4
Sex:Female
Location:Utah
Vaccinated:1992-03-16
Onset:1992-03-16
Submitted:1992-03-17
Entered:1992-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 314960 / 4 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M160HH / 4 RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1714S / 1 RA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 312918 / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Dyspnoea, Leukocytosis, Pneumonia

Life Threatening? Yes
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? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: asthma
Allergies:
Diagnostic Lab Data: 17MAR92 6AM WBC 32,000;
CDC 'Split Type': UT920013

Write-up: 16MAR92 pt recvd DTP/OPV/MMR/HIB a/noon; 8PM pt was exp difficulty breathing; had a prev dx of asthma, taken to local ER; not responding to tx for astham; later life-flighted to hosp x 3 days; 17MAR92 WBC 32,000; dx pneumonia;


Changed on 10/14/2018

VAERS ID: 42838 Before After
VAERS Form:1
Age:1.4
Sex:Female
Location:Utah
Vaccinated:1992-03-16
Onset:1992-03-16
Submitted:1992-03-17
Entered:1992-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 314960 / 4 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M160HH / 4 RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1714S / 1 RA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 312918 / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Dyspnoea, Leukocytosis, Pneumonia

Life Threatening? Yes
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? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: asthma
Allergies:
Diagnostic Lab Data: 17MAR92 6AM WBC 32,000;
CDC 'Split Type': UT920013

Write-up: 16MAR92 pt recvd DTP/OPV/MMR/HIB a/noon; 8PM pt was exp difficulty breathing; had a prev dx of asthma, taken to local ER; not responding to tx for astham; later life-flighted to hosp x 3 days; 17MAR92 WBC 32,000; dx pneumonia;

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=42838&WAYBACKHISTORY=ON


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