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This is VAERS ID 43649

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 43649
VAERS Form:
Age:1.8
Sex:Male
Location:Kansas
Vaccinated:1992-05-18
Onset:1992-05-28
Submitted:1992-06-03
Entered:1992-07-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 312934 / 2 RL / IM
HIBV: HIBTITER / LEDERLE(PRAXIS) 140HJ / 0 LL / IM
MMR: MMR II / MSD 1141T / 0 LA / SC
OPV: ORIMUNE / LEDERLE 312925 / 2 - / PO

Administered by: Public      Purchased by: Unknown
Symptoms: CONVULS, FEVER, ANEMIA HYPOCHROM, PHARYNGITIS

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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 27MAY92 fever; 28MAY92 fever up to 105 a; 1030PM pt had sz in bed; taken to ER; 2AM spinal tap-?mengitis; Spinal tap-OK; red throat; ears OK; hemoglobin 8gm;


Changed on 12/8/2009

VAERS ID: 43649 Before After
VAERS Form:
Age:1.8
Sex:Male
Location:Kansas
Vaccinated:1992-05-18
Onset:1992-05-28
Submitted:1992-06-03
Entered:1992-07-24 1992-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL DTP (TRI-IMMUNOL) / LEDERLE LEDERLE LABORATORIES 312934 / 2 RL / IM
HIBV: HIBTITER HIB (HIBTITER) / LEDERLE(PRAXIS) LEDERLE PRAXSIS 140HJ / 0 LL / IM
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 1141T / 0 LA / SC
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES 312925 / 2 - / PO

Administered by: Public      Purchased by: Unknown Public
Symptoms: Convulsion, Hypochromic anaemia, Pharyngitis, Pyrexia, CONVULS, FEVER, ANEMIA HYPOCHROM, PHARYNGITIS

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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) KS92046

Write-up: 27MAY92 fever; 28MAY92 fever up to 105 a; 1030PM pt had sz in bed; taken to ER; 2AM spinal tap-?mengitis; Spinal tap-OK; red throat; ears OK; hemoglobin 8gm;


Changed on 5/14/2017

VAERS ID: 43649 Before After
VAERS Form:
Age:1.8
Sex:Male
Location:Kansas
Vaccinated:1992-05-18
Onset:1992-05-28
Submitted:1992-06-03
Entered:1992-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 312934 / 2 RL / IM
HIBV: HIB (HIBTITER) / LEDERLE PRAXSIS PFIZER/WYETH 140HJ / 0 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1141T / 0 LA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 312925 / 2 - / PO

Administered by: Public      Purchased by: Public
Symptoms: Convulsion, Hypochromic anaemia, Pharyngitis, Pyrexia

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: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': KS92046

Write-up: 27MAY92 fever; 28MAY92 fever up to 105 a; 1030PM pt had sz in bed; taken to ER; 2AM spinal tap-?mengitis; Spinal tap-OK; red throat; ears OK; hemoglobin 8gm;


Changed on 9/14/2017

VAERS ID: 43649 Before After
VAERS Form:(blank) 1
Age:1.8
Sex:Male
Location:Kansas
Vaccinated:1992-05-18
Onset:1992-05-28
Submitted:1992-06-03
Entered:1992-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 312934 / 2 3 RL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH 140HJ / 0 1 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1141T / 0 1 LA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 312925 / 2 3 - MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Convulsion, Hypochromic anaemia, Pharyngitis, Pyrexia

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: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': KS92046

Write-up: 27MAY92 fever; 28MAY92 fever up to 105 a; 1030PM pt had sz in bed; taken to ER; 2AM spinal tap-?mengitis; Spinal tap-OK; red throat; ears OK; hemoglobin 8gm;


Changed on 2/14/2018

VAERS ID: 43649 Before After
VAERS Form:1
Age:1.8
Sex:Male
Location:Kansas
Vaccinated:1992-05-18
Onset:1992-05-28
Submitted:1992-06-03
Entered:1992-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 312934 / 3 RL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH 140HJ / 1 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1141T / 1 LA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 312925 / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Convulsion, Hypochromic anaemia, Pharyngitis, Pyrexia

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: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': KS92046

Write-up: 27MAY92 fever; 28MAY92 fever up to 105 a; 1030PM pt had sz in bed; taken to ER; 2AM spinal tap-?mengitis; Spinal tap-OK; red throat; ears OK; hemoglobin 8gm;


Changed on 6/14/2018

VAERS ID: 43649 Before After
VAERS Form:1
Age:1.8
Sex:Male
Location:Kansas
Vaccinated:1992-05-18
Onset:1992-05-28
Submitted:1992-06-03
Entered:1992-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 312934 / 3 RL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH 140HJ / 1 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1141T / 1 LA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 312925 / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Convulsion, Hypochromic anaemia, Pharyngitis, Pyrexia

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: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': KS92046

Write-up: 27MAY92 fever; 28MAY92 fever up to 105 a; 1030PM pt had sz in bed; taken to ER; 2AM spinal tap-?mengitis; Spinal tap-OK; red throat; ears OK; hemoglobin 8gm;


Changed on 8/14/2018

VAERS ID: 43649 Before After
VAERS Form:1
Age:1.8
Sex:Male
Location:Kansas
Vaccinated:1992-05-18
Onset:1992-05-28
Submitted:1992-06-03
Entered:1992-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 312934 / 3 RL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH 140HJ / 1 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1141T / 1 LA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 312925 / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Convulsion, Hypochromic anaemia, Pharyngitis, Pyrexia

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: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': KS92046

Write-up: 27MAY92 fever; 28MAY92 fever up to 105 a; 1030PM pt had sz in bed; taken to ER; 2AM spinal tap-?mengitis; Spinal tap-OK; red throat; ears OK; hemoglobin 8gm;


Changed on 9/14/2018

VAERS ID: 43649 Before After
VAERS Form:1
Age:1.8
Sex:Male
Location:Kansas
Vaccinated:1992-05-18
Onset:1992-05-28
Submitted:1992-06-03
Entered:1992-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 312934 / 3 RL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH 140HJ / 1 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1141T / 1 LA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 312925 / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Convulsion, Hypochromic anaemia, Pharyngitis, Pyrexia

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: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': KS92046

Write-up: 27MAY92 fever; 28MAY92 fever up to 105 a; 1030PM pt had sz in bed; taken to ER; 2AM spinal tap-?mengitis; Spinal tap-OK; red throat; ears OK; hemoglobin 8gm;


Changed on 10/14/2018

VAERS ID: 43649 Before After
VAERS Form:1
Age:1.8
Sex:Male
Location:Kansas
Vaccinated:1992-05-18
Onset:1992-05-28
Submitted:1992-06-03
Entered:1992-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 312934 / 3 RL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH 140HJ / 1 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1141T / 1 LA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 312925 / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Convulsion, Hypochromic anaemia, Pharyngitis, Pyrexia

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: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': KS92046

Write-up: 27MAY92 fever; 28MAY92 fever up to 105 a; 1030PM pt had sz in bed; taken to ER; 2AM spinal tap-?mengitis; Spinal tap-OK; red throat; ears OK; hemoglobin 8gm;

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