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This is VAERS ID 42850

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 42850
VAERS Form:
Age:2.0
Sex:Female
Location:Missouri
Vaccinated:1992-06-02
Onset:1992-06-04
Submitted:1992-06-05
Entered:1992-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 318909 / 2 RA / IM
HIBV: HIBTITER / LEDERLE(PRAXIS) M180HH / 1 RA / IM
MMR: MMR II / MSD 1662T / 0 LA / SC
OPV: ORIMUNE / LEDERLE 0644A / 2 - / PO

Administered by: Public      Purchased by: Unknown
Symptoms: HYPOTONIA, LEUKOCYTOSIS, COUGH INC, OTITIS MED, HYPOGLYCEM

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: 5JUN on ATB for ear infection & congest
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Blood work-low blood sugar, white count inc; CAT Scan neg; UA-neg; 10% dextrose IV push given in ER:
CDC 'Split Type': NONE

Write-up: 2JUN local discomfort; no fever; 3JUN low grade fever; coughing & clear runny nose; 4JUN awoke 10AM fussy, whimpering; laid down on kitchen floor; in car pt slump forward & was unresponsive; seen in ER: was awake w/minimal response to tests


Changed on 12/8/2009

VAERS ID: 42850 Before After
VAERS Form:
Age:2.0
Sex:Female
Location:Missouri
Vaccinated:1992-06-02
Onset:1992-06-04
Submitted:1992-06-05
Entered:1992-06-19 1992-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL DTP (TRI-IMMUNOL) / LEDERLE LEDERLE LABORATORIES 318909 / 2 RA / IM
HIBV: HIBTITER HIB (HIBTITER) / LEDERLE(PRAXIS) LEDERLE PRAXSIS M180HH / 1 RA / IM
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 1662T / 0 LA / SC
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES 0644A / 2 - / PO

Administered by: Public      Purchased by: Unknown Public
Symptoms: Cough, Hypoglycaemia, Hypotonia, Injection site pain, Leukocytosis, Otitis media, Rhinitis, Stupor, HYPOTONIA, LEUKOCYTOSIS, COUGH INC, OTITIS MED, HYPOGLYCEM

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: 5JUN on ATB for ear infection & congest
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Blood work-low blood sugar, white count inc; CAT Scan neg; UA-neg; 10% dextrose IV push given in ER:
CDC 'Split Type': NONE MO92039

Write-up: 2JUN local discomfort; no fever; 3JUN low grade fever; coughing & clear runny nose; 4JUN awoke 10AM fussy, whimpering; laid down on kitchen floor; in car pt slump forward & was unresponsive; seen in ER: was awake w/minimal response to tests


Changed on 5/14/2017

VAERS ID: 42850 Before After
VAERS Form:
Age:2.0
Sex:Female
Location:Missouri
Vaccinated:1992-06-02
Onset:1992-06-04
Submitted:1992-06-05
Entered:1992-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 318909 / 2 RA / IM
HIBV: HIB (HIBTITER) / LEDERLE PRAXSIS PFIZER/WYETH M180HH / 1 RA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1662T / 0 LA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 0644A / 2 - / PO

Administered by: Public      Purchased by: Public
Symptoms: Cough, Hypoglycaemia, Hypotonia, Injection site pain, Leukocytosis, Otitis media, Rhinitis, Stupor

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: NONE NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: 5JUN on ATB for ear infection & congest
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Blood work-low blood sugar, white count inc; CAT Scan neg; UA-neg; 10% dextrose IV push given in ER:
CDC 'Split Type': MO92039

Write-up: 2JUN local discomfort; no fever; 3JUN low grade fever; coughing & clear runny nose; 4JUN awoke 10AM fussy, whimpering; laid down on kitchen floor; in car pt slump forward & was unresponsive; seen in ER: was awake w/minimal response to tests


Changed on 9/14/2017

VAERS ID: 42850 Before After
VAERS Form:(blank) 1
Age:2.0
Sex:Female
Location:Missouri
Vaccinated:1992-06-02
Onset:1992-06-04
Submitted:1992-06-05
Entered:1992-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 318909 / 2 3 RA / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M180HH / 1 2 RA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1662T / 0 1 LA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0644A / 2 3 - MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Cough, Hypoglycaemia, Hypotonia, Injection site pain, Leukocytosis, Otitis media, Rhinitis, Stupor

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: 5JUN on ATB for ear infection & congest
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Blood work-low blood sugar, white count inc; CAT Scan neg; UA-neg; 10% dextrose IV push given in ER:
CDC 'Split Type': MO92039

Write-up: 2JUN local discomfort; no fever; 3JUN low grade fever; coughing & clear runny nose; 4JUN awoke 10AM fussy, whimpering; laid down on kitchen floor; in car pt slump forward & was unresponsive; seen in ER: was awake w/minimal response to tests


Changed on 2/14/2018

VAERS ID: 42850 Before After
VAERS Form:1
Age:2.0
Sex:Female
Location:Missouri
Vaccinated:1992-06-02
Onset:1992-06-04
Submitted:1992-06-05
Entered:1992-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 318909 / 3 RA / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M180HH / 2 RA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1662T / 1 LA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0644A / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Cough, Hypoglycaemia, Hypotonia, Injection site pain, Leukocytosis, Otitis media, Rhinitis, Stupor

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: 5JUN on ATB for ear infection & congest
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Blood work-low blood sugar, white count inc; CAT Scan neg; UA-neg; 10% dextrose IV push given in ER:
CDC 'Split Type': MO92039

Write-up: 2JUN local discomfort; no fever; 3JUN low grade fever; coughing & clear runny nose; 4JUN awoke 10AM fussy, whimpering; laid down on kitchen floor; in car pt slump forward & was unresponsive; seen in ER: was awake w/minimal response to tests


Changed on 6/14/2018

VAERS ID: 42850 Before After
VAERS Form:1
Age:2.0
Sex:Female
Location:Missouri
Vaccinated:1992-06-02
Onset:1992-06-04
Submitted:1992-06-05
Entered:1992-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 318909 / 3 RA / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M180HH / 2 RA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1662T / 1 LA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0644A / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Cough, Hypoglycaemia, Hypotonia, Injection site pain, Leukocytosis, Otitis media, Rhinitis, Stupor

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: 5JUN on ATB for ear infection & congest
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Blood work-low blood sugar, white count inc; CAT Scan neg; UA-neg; 10% dextrose IV push given in ER:
CDC 'Split Type': MO92039

Write-up: 2JUN local discomfort; no fever; 3JUN low grade fever; coughing & clear runny nose; 4JUN awoke 10AM fussy, whimpering; laid down on kitchen floor; in car pt slump forward & was unresponsive; seen in ER: was awake w/minimal response to tests


Changed on 8/14/2018

VAERS ID: 42850 Before After
VAERS Form:1
Age:2.0
Sex:Female
Location:Missouri
Vaccinated:1992-06-02
Onset:1992-06-04
Submitted:1992-06-05
Entered:1992-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 318909 / 3 RA / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M180HH / 2 RA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1662T / 1 LA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0644A / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Cough, Hypoglycaemia, Hypotonia, Injection site pain, Leukocytosis, Otitis media, Rhinitis, Stupor

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: 5JUN on ATB for ear infection & congest
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Blood work-low blood sugar, white count inc; CAT Scan neg; UA-neg; 10% dextrose IV push given in ER:
CDC 'Split Type': MO92039

Write-up: 2JUN local discomfort; no fever; 3JUN low grade fever; coughing & clear runny nose; 4JUN awoke 10AM fussy, whimpering; laid down on kitchen floor; in car pt slump forward & was unresponsive; seen in ER: was awake w/minimal response to tests


Changed on 9/14/2018

VAERS ID: 42850 Before After
VAERS Form:1
Age:2.0
Sex:Female
Location:Missouri
Vaccinated:1992-06-02
Onset:1992-06-04
Submitted:1992-06-05
Entered:1992-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 318909 / 3 RA / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M180HH / 2 RA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1662T / 1 LA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0644A / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Cough, Hypoglycaemia, Hypotonia, Injection site pain, Leukocytosis, Otitis media, Rhinitis, Stupor

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: 5JUN on ATB for ear infection & congest
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Blood work-low blood sugar, white count inc; CAT Scan neg; UA-neg; 10% dextrose IV push given in ER:
CDC 'Split Type': MO92039

Write-up: 2JUN local discomfort; no fever; 3JUN low grade fever; coughing & clear runny nose; 4JUN awoke 10AM fussy, whimpering; laid down on kitchen floor; in car pt slump forward & was unresponsive; seen in ER: was awake w/minimal response to tests


Changed on 10/14/2018

VAERS ID: 42850 Before After
VAERS Form:1
Age:2.0
Sex:Female
Location:Missouri
Vaccinated:1992-06-02
Onset:1992-06-04
Submitted:1992-06-05
Entered:1992-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 318909 / 3 RA / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M180HH / 2 RA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1662T / 1 LA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0644A / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Cough, Hypoglycaemia, Hypotonia, Injection site pain, Leukocytosis, Otitis media, Rhinitis, Stupor

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: 5JUN on ATB for ear infection & congest
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Blood work-low blood sugar, white count inc; CAT Scan neg; UA-neg; 10% dextrose IV push given in ER:
CDC 'Split Type': MO92039

Write-up: 2JUN local discomfort; no fever; 3JUN low grade fever; coughing & clear runny nose; 4JUN awoke 10AM fussy, whimpering; laid down on kitchen floor; in car pt slump forward & was unresponsive; seen in ER: was awake w/minimal response to tests

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