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This is VAERS ID 43332

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 43332
VAERS Form:
Age:1.2
Sex:Female
Location:Florida
Vaccinated:1991-03-13
Onset:1991-03-27
Submitted:1992-05-22
Entered:1992-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 285966 / 3 RL / -
HIBV: PROHIBIT / CONNAUGHT LABS 0A21092 / 0 LL / -
MMR: MMR II / MSD 1341S / 0 LA / -
OPV: ORIMUNE / LEDERLE 281940 / 2 - / PO

Administered by: Public      Purchased by: Unknown
Symptoms: HYPOKINESIA, INFECT, MYELITIS, GASTROENTERITIS, INCONTIN URIN

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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? No
Previous Vaccinations: NONE
Other Medications: APAP
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: 27MAR92 nerve conduction study suggested an intre-axial lesion but no demyelinating process; 3APR91 Somatosensory evoked potential exam no nerve activity; 11APR91 d/c dx tranverse myelitis unk etiology; neurogenic bladder;
CDC 'Split Type': NONE

Write-up: 23MAR91 to ER w/diffuse rash, diarrhea & temp 39R; dx viral gastroenteritis, sent home; 27MAR91 woke up w/dry diaper, mom concerned about dehydration, took pt to ER; pt had no feeling or movement of lower extremities; dec sensation t8-t10;


Changed on 12/8/2009

VAERS ID: 43332 Before After
VAERS Form:
Age:1.2
Sex:Female
Location:Florida
Vaccinated:1991-03-13
Onset:1991-03-27
Submitted:1992-05-22
Entered:1992-07-09 1992-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL DTP (TRI-IMMUNOL) / LEDERLE LEDERLE LABORATORIES 285966 / 3 RL / -
HIBV: PROHIBIT HIB (PROHIBIT) / CONNAUGHT LABS CONNAUGHT LABORATORIES 0A21092 / 0 LL / -
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 1341S / 0 LA / -
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES 281940 / 2 - / PO

Administered by: Public      Purchased by: Unknown Public
Symptoms: Gastroenteritis, Hypokinesia, Hyporeflexia, Infection, Myelitis, Neuropathy, Paraesthesia, Urinary incontinence, HYPOKINESIA, INFECT, MYELITIS, GASTROENTERITIS, INCONTIN URIN

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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? No
Previous Vaccinations: NONE
Other Medications: APAP
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: 27MAR92 nerve conduction study suggested an intre-axial lesion but no demyelinating process; 3APR91 Somatosensory evoked potential exam no nerve activity; 11APR91 d/c dx tranverse myelitis unk etiology; neurogenic bladder;
CDC 'Split Type': NONE FL91081

Write-up: 23MAR91 to ER w/diffuse rash, diarrhea & temp 39R; dx viral gastroenteritis, sent home; 27MAR91 woke up w/dry diaper, mom concerned about dehydration, took pt to ER; pt had no feeling or movement of lower extremities; dec sensation t8-t10;


Changed on 5/14/2017

VAERS ID: 43332 Before After
VAERS Form:
Age:1.2
Sex:Female
Location:Florida
Vaccinated:1991-03-13
Onset:1991-03-27
Submitted:1992-05-22
Entered:1992-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 285966 / 3 RL / -
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0A21092 / 0 LL / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1341S / 0 LA / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 281940 / 2 - / PO

Administered by: Public      Purchased by: Public
Symptoms: Gastroenteritis, Hypokinesia, Hyporeflexia, Infection, Myelitis, Neuropathy, Paraesthesia, Urinary incontinence

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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? No
Previous Vaccinations: NONE NONE~ ()~~~In patient
Other Medications: APAP
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: 27MAR92 nerve conduction study suggested an intre-axial lesion but no demyelinating process; 3APR91 Somatosensory evoked potential exam no nerve activity; 11APR91 d/c dx tranverse myelitis unk etiology; neurogenic bladder;
CDC 'Split Type': FL91081

Write-up: 23MAR91 to ER w/diffuse rash, diarrhea & temp 39R; dx viral gastroenteritis, sent home; 27MAR91 woke up w/dry diaper, mom concerned about dehydration, took pt to ER; pt had no feeling or movement of lower extremities; dec sensation t8-t10;


Changed on 9/14/2017

VAERS ID: 43332 Before After
VAERS Form:(blank) 1
Age:1.2
Sex:Female
Location:Florida
Vaccinated:1991-03-13
Onset:1991-03-27
Submitted:1992-05-22
Entered:1992-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 285966 / 3 4 RL / -
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0A21092 / 0 1 LL / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1341S / 0 1 LA / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 281940 / 2 3 - MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Gastroenteritis, Hypokinesia, Hyporeflexia, Infection, Myelitis, Neuropathy, Paraesthesia, Urinary incontinence

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: APAP
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: 27MAR92 nerve conduction study suggested an intre-axial lesion but no demyelinating process; 3APR91 Somatosensory evoked potential exam no nerve activity; 11APR91 d/c dx tranverse myelitis unk etiology; neurogenic bladder;
CDC 'Split Type': FL91081

Write-up: 23MAR91 to ER w/diffuse rash, diarrhea & temp 39R; dx viral gastroenteritis, sent home; 27MAR91 woke up w/dry diaper, mom concerned about dehydration, took pt to ER; pt had no feeling or movement of lower extremities; dec sensation t8-t10;


Changed on 2/14/2018

VAERS ID: 43332 Before After
VAERS Form:1
Age:1.2
Sex:Female
Location:Florida
Vaccinated:1991-03-13
Onset:1991-03-27
Submitted:1992-05-22
Entered:1992-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 285966 / 4 RL / -
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0A21092 / 1 LL / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1341S / 1 LA / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 281940 / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Gastroenteritis, Hypokinesia, Hyporeflexia, Infection, Myelitis, Neuropathy, Paraesthesia, Urinary incontinence

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: APAP
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: 27MAR92 nerve conduction study suggested an intre-axial lesion but no demyelinating process; 3APR91 Somatosensory evoked potential exam no nerve activity; 11APR91 d/c dx tranverse myelitis unk etiology; neurogenic bladder;
CDC 'Split Type': FL91081

Write-up: 23MAR91 to ER w/diffuse rash, diarrhea & temp 39R; dx viral gastroenteritis, sent home; 27MAR91 woke up w/dry diaper, mom concerned about dehydration, took pt to ER; pt had no feeling or movement of lower extremities; dec sensation t8-t10;


Changed on 6/14/2018

VAERS ID: 43332 Before After
VAERS Form:1
Age:1.2
Sex:Female
Location:Florida
Vaccinated:1991-03-13
Onset:1991-03-27
Submitted:1992-05-22
Entered:1992-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 285966 / 4 RL / -
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0A21092 / 1 LL / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1341S / 1 LA / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 281940 / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Gastroenteritis, Hypokinesia, Hyporeflexia, Infection, Myelitis, Neuropathy, Paraesthesia, Urinary incontinence

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: APAP
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: 27MAR92 nerve conduction study suggested an intre-axial lesion but no demyelinating process; 3APR91 Somatosensory evoked potential exam no nerve activity; 11APR91 d/c dx tranverse myelitis unk etiology; neurogenic bladder;
CDC 'Split Type': FL91081

Write-up: 23MAR91 to ER w/diffuse rash, diarrhea & temp 39R; dx viral gastroenteritis, sent home; 27MAR91 woke up w/dry diaper, mom concerned about dehydration, took pt to ER; pt had no feeling or movement of lower extremities; dec sensation t8-t10;


Changed on 8/14/2018

VAERS ID: 43332 Before After
VAERS Form:1
Age:1.2
Sex:Female
Location:Florida
Vaccinated:1991-03-13
Onset:1991-03-27
Submitted:1992-05-22
Entered:1992-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 285966 / 4 RL / -
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0A21092 / 1 LL / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1341S / 1 LA / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 281940 / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Gastroenteritis, Hypokinesia, Hyporeflexia, Infection, Myelitis, Neuropathy, Paraesthesia, Urinary incontinence

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: APAP
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: 27MAR92 nerve conduction study suggested an intre-axial lesion but no demyelinating process; 3APR91 Somatosensory evoked potential exam no nerve activity; 11APR91 d/c dx tranverse myelitis unk etiology; neurogenic bladder;
CDC 'Split Type': FL91081

Write-up: 23MAR91 to ER w/diffuse rash, diarrhea & temp 39R; dx viral gastroenteritis, sent home; 27MAR91 woke up w/dry diaper, mom concerned about dehydration, took pt to ER; pt had no feeling or movement of lower extremities; dec sensation t8-t10;


Changed on 9/14/2018

VAERS ID: 43332 Before After
VAERS Form:1
Age:1.2
Sex:Female
Location:Florida
Vaccinated:1991-03-13
Onset:1991-03-27
Submitted:1992-05-22
Entered:1992-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 285966 / 4 RL / -
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0A21092 / 1 LL / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1341S / 1 LA / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 281940 / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Gastroenteritis, Hypokinesia, Hyporeflexia, Infection, Myelitis, Neuropathy, Paraesthesia, Urinary incontinence

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: APAP
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: 27MAR92 nerve conduction study suggested an intre-axial lesion but no demyelinating process; 3APR91 Somatosensory evoked potential exam no nerve activity; 11APR91 d/c dx tranverse myelitis unk etiology; neurogenic bladder;
CDC 'Split Type': FL91081

Write-up: 23MAR91 to ER w/diffuse rash, diarrhea & temp 39R; dx viral gastroenteritis, sent home; 27MAR91 woke up w/dry diaper, mom concerned about dehydration, took pt to ER; pt had no feeling or movement of lower extremities; dec sensation t8-t10;


Changed on 10/14/2018

VAERS ID: 43332 Before After
VAERS Form:1
Age:1.2
Sex:Female
Location:Florida
Vaccinated:1991-03-13
Onset:1991-03-27
Submitted:1992-05-22
Entered:1992-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 285966 / 4 RL / -
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0A21092 / 1 LL / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1341S / 1 LA / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 281940 / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Gastroenteritis, Hypokinesia, Hyporeflexia, Infection, Myelitis, Neuropathy, Paraesthesia, Urinary incontinence

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: APAP
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: 27MAR92 nerve conduction study suggested an intre-axial lesion but no demyelinating process; 3APR91 Somatosensory evoked potential exam no nerve activity; 11APR91 d/c dx tranverse myelitis unk etiology; neurogenic bladder;
CDC 'Split Type': FL91081

Write-up: 23MAR91 to ER w/diffuse rash, diarrhea & temp 39R; dx viral gastroenteritis, sent home; 27MAR91 woke up w/dry diaper, mom concerned about dehydration, took pt to ER; pt had no feeling or movement of lower extremities; dec sensation t8-t10;

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