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This is VAERS ID 45433

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 45433
VAERS Form:
Age:2.2
Sex:Female
Location:North Carolina
Vaccinated:1992-08-28
Onset:1992-08-28
Submitted:1992-09-18
Entered:1992-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 2G31010 / 3 RL / IM
HIBV: PROHIBIT / CONNAUGHT LABS 0J21073 / 2 LL / IM
MMR: MMR II / MSD 0666V / 0 LA / IM
OPV: ORIMUNE / LEDERLE 0655E / 2 - / PO

Administered by: Private      Purchased by: Unknown
Symptoms: CONVULS, SOMNOLENCE, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: WBX 13.1 w/ 57% Polys; 34% lymphs; EEG-neg;
CDC 'Split Type':

Write-up: approx 2 days p/revd pt was noted to be unresponsive to verbal & tactile stimuli; then started to have t/c sz activity x 2-3 mins w/5 mins of postictal lethargy;


Changed on 12/8/2009

VAERS ID: 45433 Before After
VAERS Form:
Age:2.2
Sex:Female
Location:North Carolina
Vaccinated:1992-08-28
Onset:1992-08-28
Submitted:1992-09-18
Entered:1992-09-25 1992-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL DTP (TRI-IMMUNOL) / LEDERLE LEDERLE LABORATORIES 2G31010 / 3 RL / IM
HIBV: PROHIBIT HIB (PROHIBIT) / CONNAUGHT LABS CONNAUGHT LABORATORIES 0J21073 / 2 LL / IM
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 0666V / 0 LA / IM
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES 0655E / 2 - / PO

Administered by: Private      Purchased by: Unknown Private
Symptoms: Convulsion, Somnolence, Stupor, CONVULS, SOMNOLENCE, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: WBX 13.1 w/ 57% Polys; 34% lymphs; EEG-neg;
CDC 'Split Type':

Write-up: approx 2 days p/revd pt was noted to be unresponsive to verbal & tactile stimuli; then started to have t/c sz activity x 2-3 mins w/5 mins of postictal lethargy;


Changed on 2/14/2017

VAERS ID: 45433 Before After
VAERS Form:
Age:2.2 2.0
Sex:Female
Location:North Carolina
Vaccinated:1992-08-28
Onset:1992-08-28
Submitted:1992-09-18
Entered:1992-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 2G31010 / 3 RL / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0J21073 / 2 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0666V / 0 LA / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES 0655E / 2 - / PO

Administered by: Private      Purchased by: Private
Symptoms: Convulsion, Somnolence, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: WBX 13.1 w/ 57% Polys; 34% lymphs; EEG-neg;
CDC 'Split Type':

Write-up: approx 2 days p/revd pt was noted to be unresponsive to verbal & tactile stimuli; then started to have t/c sz activity x 2-3 mins w/5 mins of postictal lethargy;


Changed on 5/14/2017

VAERS ID: 45433 Before After
VAERS Form:
Age:2.0
Sex:Female
Location:North Carolina
Vaccinated:1992-08-28
Onset:1992-08-28
Submitted:1992-09-18
Entered:1992-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 2G31010 / 3 RL / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0J21073 / 2 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0666V / 0 LA / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 0655E / 2 - / PO

Administered by: Private      Purchased by: Private
Symptoms: Convulsion, Somnolence, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: WBX 13.1 w/ 57% Polys; 34% lymphs; EEG-neg;
CDC 'Split Type':

Write-up: approx 2 days p/revd pt was noted to be unresponsive to verbal & tactile stimuli; then started to have t/c sz activity x 2-3 mins w/5 mins of postictal lethargy;


Changed on 9/14/2017

VAERS ID: 45433 Before After
VAERS Form:(blank) 1
Age:2.0
Sex:Female
Location:North Carolina
Vaccinated:1992-08-28
Onset:1992-08-28
Submitted:1992-09-18
Entered:1992-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 2G31010 / 3 4 RL / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0J21073 / 2 3 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0666V / 0 1 LA / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0655E / 2 3 - MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Convulsion, Somnolence, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: WBX 13.1 w/ 57% Polys; 34% lymphs; EEG-neg;
CDC 'Split Type':

Write-up: approx 2 days p/revd pt was noted to be unresponsive to verbal & tactile stimuli; then started to have t/c sz activity x 2-3 mins w/5 mins of postictal lethargy;


Changed on 2/14/2018

VAERS ID: 45433 Before After
VAERS Form:1
Age:2.0
Sex:Female
Location:North Carolina
Vaccinated:1992-08-28
Onset:1992-08-28
Submitted:1992-09-18
Entered:1992-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 2G31010 / 4 RL / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0J21073 / 3 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0666V / 1 LA / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0655E / 3 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Convulsion, Somnolence, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: WBX 13.1 w/ 57% Polys; 34% lymphs; EEG-neg;
CDC 'Split Type':

Write-up: approx 2 days p/revd pt was noted to be unresponsive to verbal & tactile stimuli; then started to have t/c sz activity x 2-3 mins w/5 mins of postictal lethargy;


Changed on 6/14/2018

VAERS ID: 45433 Before After
VAERS Form:1
Age:2.0
Sex:Female
Location:North Carolina
Vaccinated:1992-08-28
Onset:1992-08-28
Submitted:1992-09-18
Entered:1992-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 2G31010 / 4 RL / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0J21073 / 3 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0666V / 1 LA / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0655E / 3 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Convulsion, Somnolence, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: WBX 13.1 w/ 57% Polys; 34% lymphs; EEG-neg;
CDC 'Split Type':

Write-up: approx 2 days p/revd pt was noted to be unresponsive to verbal & tactile stimuli; then started to have t/c sz activity x 2-3 mins w/5 mins of postictal lethargy;


Changed on 8/14/2018

VAERS ID: 45433 Before After
VAERS Form:1
Age:2.0
Sex:Female
Location:North Carolina
Vaccinated:1992-08-28
Onset:1992-08-28
Submitted:1992-09-18
Entered:1992-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 2G31010 / 4 RL / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0J21073 / 3 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0666V / 1 LA / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0655E / 3 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Convulsion, Somnolence, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: WBX 13.1 w/ 57% Polys; 34% lymphs; EEG-neg;
CDC 'Split Type':

Write-up: approx 2 days p/revd pt was noted to be unresponsive to verbal & tactile stimuli; then started to have t/c sz activity x 2-3 mins w/5 mins of postictal lethargy;


Changed on 9/14/2018

VAERS ID: 45433 Before After
VAERS Form:1
Age:2.0
Sex:Female
Location:North Carolina
Vaccinated:1992-08-28
Onset:1992-08-28
Submitted:1992-09-18
Entered:1992-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 2G31010 / 4 RL / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0J21073 / 3 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0666V / 1 LA / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0655E / 3 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Convulsion, Somnolence, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: WBX 13.1 w/ 57% Polys; 34% lymphs; EEG-neg;
CDC 'Split Type':

Write-up: approx 2 days p/revd pt was noted to be unresponsive to verbal & tactile stimuli; then started to have t/c sz activity x 2-3 mins w/5 mins of postictal lethargy;


Changed on 10/14/2018

VAERS ID: 45433 Before After
VAERS Form:1
Age:2.0
Sex:Female
Location:North Carolina
Vaccinated:1992-08-28
Onset:1992-08-28
Submitted:1992-09-18
Entered:1992-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 2G31010 / 4 RL / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0J21073 / 3 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0666V / 1 LA / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0655E / 3 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Convulsion, Somnolence, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: WBX 13.1 w/ 57% Polys; 34% lymphs; EEG-neg;
CDC 'Split Type':

Write-up: approx 2 days p/revd pt was noted to be unresponsive to verbal & tactile stimuli; then started to have t/c sz activity x 2-3 mins w/5 mins of postictal lethargy;

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