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This is VAERS ID 43310

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 43310
VAERS Form:
Age:1.4
Sex:Female
Location:Texas
Vaccinated:1992-01-07
Onset:1992-01-08
Submitted:1992-06-12
Entered:1992-07-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIBTITER / LEDERLE(PRAXIS) M160HF / 1 L / IM
MMR: MMR II / MSD 0983T / 0 L / IM

Administered by: Private      Purchased by: Unknown
Symptoms: FEVER, MALAISE, DIARRHEA, ENCEPHALOPATHY, ATAXIA

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: multiple tests @ hosp;
CDC 'Split Type': NONE

Write-up: Pt recvd MMR/HIB 7JAN92 & seen in clinic w/fever, vomiting, diarrhea 10JAN92; 13JAN92 was much improved; seen in clinic 6MAR92 w/ataxia, listlessness adm to hos 17MAR92 dx leukoencephalopathy


Changed on 12/8/2009

VAERS ID: 43310 Before After
VAERS Form:
Age:1.4
Sex:Female
Location:Texas
Vaccinated:1992-01-07
Onset:1992-01-08
Submitted:1992-06-12
Entered:1992-07-06 1992-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIBTITER HIB (HIBTITER) / LEDERLE(PRAXIS) LEDERLE PRAXSIS M160HF / 1 L / IM
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 0983T / 0 L / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Coordination abnormal, Diarrhoea, Encephalopathy, Malaise, Pyrexia, Vomiting, FEVER, MALAISE, DIARRHEA, ENCEPHALOPATHY, ATAXIA

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: multiple tests @ hosp;
CDC 'Split Type': NONE (blank)

Write-up: Pt recvd MMR/HIB 7JAN92 & seen in clinic w/fever, vomiting, diarrhea 10JAN92; 13JAN92 was much improved; seen in clinic 6MAR92 w/ataxia, listlessness adm to hos 17MAR92 dx leukoencephalopathy


Changed on 5/14/2017

VAERS ID: 43310 Before After
VAERS Form:
Age:1.4
Sex:Female
Location:Texas
Vaccinated:1992-01-07
Onset:1992-01-08
Submitted:1992-06-12
Entered:1992-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / LEDERLE PRAXSIS PFIZER/WYETH M160HF / 1 L - / IM IM L
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0983T / 0 L - / IM IM L

Administered by: Private      Purchased by: Private
Symptoms: Coordination abnormal, Diarrhoea, Encephalopathy, Malaise, Pyrexia, Vomiting

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations: NONE NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: multiple tests @ hosp;
CDC 'Split Type':

Write-up: Pt recvd MMR/HIB 7JAN92 & seen in clinic w/fever, vomiting, diarrhea 10JAN92; 13JAN92 was much improved; seen in clinic 6MAR92 w/ataxia, listlessness adm to hos 17MAR92 dx leukoencephalopathy


Changed on 9/14/2017

VAERS ID: 43310 Before After
VAERS Form:(blank) 1
Age:1.4
Sex:Female
Location:Texas
Vaccinated:1992-01-07
Onset:1992-01-08
Submitted:1992-06-12
Entered:1992-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH M160HF / 1 2 - / IM L
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0983T / 0 1 - / IM L

Administered by: Private      Purchased by: Private
Symptoms: Coordination abnormal, Diarrhoea, Encephalopathy, Malaise, Pyrexia, Vomiting

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: multiple tests @ hosp;
CDC 'Split Type':

Write-up: Pt recvd MMR/HIB 7JAN92 & seen in clinic w/fever, vomiting, diarrhea 10JAN92; 13JAN92 was much improved; seen in clinic 6MAR92 w/ataxia, listlessness adm to hos 17MAR92 dx leukoencephalopathy


Changed on 2/14/2018

VAERS ID: 43310 Before After
VAERS Form:1
Age:1.4
Sex:Female
Location:Texas
Vaccinated:1992-01-07
Onset:1992-01-08
Submitted:1992-06-12
Entered:1992-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH M160HF / 2 - / IM L
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0983T / 1 - / IM L

Administered by: Private      Purchased by: Private
Symptoms: Coordination abnormal, Diarrhoea, Encephalopathy, Malaise, Pyrexia, Vomiting

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: multiple tests @ hosp;
CDC 'Split Type':

Write-up: Pt recvd MMR/HIB 7JAN92 & seen in clinic w/fever, vomiting, diarrhea 10JAN92; 13JAN92 was much improved; seen in clinic 6MAR92 w/ataxia, listlessness adm to hos 17MAR92 dx leukoencephalopathy


Changed on 6/14/2018

VAERS ID: 43310 Before After
VAERS Form:1
Age:1.4
Sex:Female
Location:Texas
Vaccinated:1992-01-07
Onset:1992-01-08
Submitted:1992-06-12
Entered:1992-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH M160HF / 2 - / IM L
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0983T / 1 - / IM L

Administered by: Private      Purchased by: Private
Symptoms: Coordination abnormal, Diarrhoea, Encephalopathy, Malaise, Pyrexia, Vomiting

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: multiple tests @ hosp;
CDC 'Split Type':

Write-up: Pt recvd MMR/HIB 7JAN92 & seen in clinic w/fever, vomiting, diarrhea 10JAN92; 13JAN92 was much improved; seen in clinic 6MAR92 w/ataxia, listlessness adm to hos 17MAR92 dx leukoencephalopathy


Changed on 8/14/2018

VAERS ID: 43310 Before After
VAERS Form:1
Age:1.4
Sex:Female
Location:Texas
Vaccinated:1992-01-07
Onset:1992-01-08
Submitted:1992-06-12
Entered:1992-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH M160HF / 2 - / IM L
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0983T / 1 - / IM L

Administered by: Private      Purchased by: Private
Symptoms: Coordination abnormal, Diarrhoea, Encephalopathy, Malaise, Pyrexia, Vomiting

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: multiple tests @ hosp;
CDC 'Split Type':

Write-up: Pt recvd MMR/HIB 7JAN92 & seen in clinic w/fever, vomiting, diarrhea 10JAN92; 13JAN92 was much improved; seen in clinic 6MAR92 w/ataxia, listlessness adm to hos 17MAR92 dx leukoencephalopathy


Changed on 9/14/2018

VAERS ID: 43310 Before After
VAERS Form:1
Age:1.4
Sex:Female
Location:Texas
Vaccinated:1992-01-07
Onset:1992-01-08
Submitted:1992-06-12
Entered:1992-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH M160HF / 2 - / IM L
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0983T / 1 - / IM L

Administered by: Private      Purchased by: Private
Symptoms: Coordination abnormal, Diarrhoea, Encephalopathy, Malaise, Pyrexia, Vomiting

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: multiple tests @ hosp;
CDC 'Split Type':

Write-up: Pt recvd MMR/HIB 7JAN92 & seen in clinic w/fever, vomiting, diarrhea 10JAN92; 13JAN92 was much improved; seen in clinic 6MAR92 w/ataxia, listlessness adm to hos 17MAR92 dx leukoencephalopathy


Changed on 10/14/2018

VAERS ID: 43310 Before After
VAERS Form:1
Age:1.4
Sex:Female
Location:Texas
Vaccinated:1992-01-07
Onset:1992-01-08
Submitted:1992-06-12
Entered:1992-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH M160HF / 2 - / IM L
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0983T / 1 - / IM L

Administered by: Private      Purchased by: Private
Symptoms: Coordination abnormal, Diarrhoea, Encephalopathy, Malaise, Pyrexia, Vomiting

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: multiple tests @ hosp;
CDC 'Split Type':

Write-up: Pt recvd MMR/HIB 7JAN92 & seen in clinic w/fever, vomiting, diarrhea 10JAN92; 13JAN92 was much improved; seen in clinic 6MAR92 w/ataxia, listlessness adm to hos 17MAR92 dx leukoencephalopathy

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