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This is VAERS ID 45957

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 45957
VAERS Form:
Age:2.0
Sex:Male
Location:Arkansas
Vaccinated:1992-07-09
Onset:1992-07-19
Submitted:1992-07-22
Entered:1992-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 322913 / 3 RA / IM
HIBV: HIBTITER / LEDERLE(PRAXIS) M695HK / 1 RL / IM
MMR: MMR II / MSD 0144V / 0 LA / SC
OPV: ORIMUNE / LEDERLE 0652K / 2 - / PO

Administered by: Public      Purchased by: Unknown
Symptoms: CONVULS, FEVER, RASH

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:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: elevated temp & rash on neck starting 19JUL92 temp went to 105.8 had sz; hospitalized over noc; mom states WBC WNL; d/c 20JUL92 had DTP/OPV/HIB/MMR/TB Tine 9JUL92; MD felt related to vax;


Changed on 12/8/2009

VAERS ID: 45957 Before After
VAERS Form:
Age:2.0
Sex:Male
Location:Arkansas
Vaccinated:1992-07-09
Onset:1992-07-19
Submitted:1992-07-22
Entered:1992-10-06 1992-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL DTP (TRI-IMMUNOL) / LEDERLE LEDERLE LABORATORIES 322913 / 3 RA / IM
HIBV: HIBTITER HIB (HIBTITER) / LEDERLE(PRAXIS) LEDERLE PRAXSIS M695HK / 1 RL / IM
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 0144V / 0 LA / SC
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES 0652K / 2 - / PO

Administered by: Public      Purchased by: Unknown Public
Symptoms: Convulsion, Pyrexia, Rash, CONVULS, FEVER, RASH

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:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) AR9243

Write-up: elevated temp & rash on neck starting 19JUL92 temp went to 105.8 had sz; hospitalized over noc; mom states WBC WNL; d/c 20JUL92 had DTP/OPV/HIB/MMR/TB Tine 9JUL92; MD felt related to vax;


Changed on 5/14/2017

VAERS ID: 45957 Before After
VAERS Form:
Age:2.0
Sex:Male
Location:Arkansas
Vaccinated:1992-07-09
Onset:1992-07-19
Submitted:1992-07-22
Entered:1992-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 322913 / 3 RA / IM
HIBV: HIB (HIBTITER) / LEDERLE PRAXSIS PFIZER/WYETH M695HK / 1 RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0144V / 0 LA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 0652K / 2 - / PO

Administered by: Public      Purchased by: Public
Symptoms: Convulsion, Pyrexia, Rash

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: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': AR9243

Write-up: elevated temp & rash on neck starting 19JUL92 temp went to 105.8 had sz; hospitalized over noc; mom states WBC WNL; d/c 20JUL92 had DTP/OPV/HIB/MMR/TB Tine 9JUL92; MD felt related to vax;


Changed on 9/14/2017

VAERS ID: 45957 Before After
VAERS Form:(blank) 1
Age:2.0
Sex:Male
Location:Arkansas
Vaccinated:1992-07-09
Onset:1992-07-19
Submitted:1992-07-22
Entered:1992-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 322913 / 3 4 RA / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M695HK / 1 2 RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0144V / 0 1 LA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0652K / 2 3 - MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Convulsion, Pyrexia, Rash

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: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': AR9243

Write-up: elevated temp & rash on neck starting 19JUL92 temp went to 105.8 had sz; hospitalized over noc; mom states WBC WNL; d/c 20JUL92 had DTP/OPV/HIB/MMR/TB Tine 9JUL92; MD felt related to vax;


Changed on 2/14/2018

VAERS ID: 45957 Before After
VAERS Form:1
Age:2.0
Sex:Male
Location:Arkansas
Vaccinated:1992-07-09
Onset:1992-07-19
Submitted:1992-07-22
Entered:1992-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 322913 / 4 RA / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M695HK / 2 RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0144V / 1 LA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0652K / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Convulsion, Pyrexia, Rash

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: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': AR9243

Write-up: elevated temp & rash on neck starting 19JUL92 temp went to 105.8 had sz; hospitalized over noc; mom states WBC WNL; d/c 20JUL92 had DTP/OPV/HIB/MMR/TB Tine 9JUL92; MD felt related to vax;


Changed on 6/14/2018

VAERS ID: 45957 Before After
VAERS Form:1
Age:2.0
Sex:Male
Location:Arkansas
Vaccinated:1992-07-09
Onset:1992-07-19
Submitted:1992-07-22
Entered:1992-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 322913 / 4 RA / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M695HK / 2 RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0144V / 1 LA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0652K / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Convulsion, Pyrexia, Rash

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: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': AR9243

Write-up: elevated temp & rash on neck starting 19JUL92 temp went to 105.8 had sz; hospitalized over noc; mom states WBC WNL; d/c 20JUL92 had DTP/OPV/HIB/MMR/TB Tine 9JUL92; MD felt related to vax;


Changed on 8/14/2018

VAERS ID: 45957 Before After
VAERS Form:1
Age:2.0
Sex:Male
Location:Arkansas
Vaccinated:1992-07-09
Onset:1992-07-19
Submitted:1992-07-22
Entered:1992-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 322913 / 4 RA / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M695HK / 2 RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0144V / 1 LA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0652K / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Convulsion, Pyrexia, Rash

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: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': AR9243

Write-up: elevated temp & rash on neck starting 19JUL92 temp went to 105.8 had sz; hospitalized over noc; mom states WBC WNL; d/c 20JUL92 had DTP/OPV/HIB/MMR/TB Tine 9JUL92; MD felt related to vax;


Changed on 9/14/2018

VAERS ID: 45957 Before After
VAERS Form:1
Age:2.0
Sex:Male
Location:Arkansas
Vaccinated:1992-07-09
Onset:1992-07-19
Submitted:1992-07-22
Entered:1992-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 322913 / 4 RA / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M695HK / 2 RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0144V / 1 LA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0652K / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Convulsion, Pyrexia, Rash

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: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': AR9243

Write-up: elevated temp & rash on neck starting 19JUL92 temp went to 105.8 had sz; hospitalized over noc; mom states WBC WNL; d/c 20JUL92 had DTP/OPV/HIB/MMR/TB Tine 9JUL92; MD felt related to vax;


Changed on 10/14/2018

VAERS ID: 45957 Before After
VAERS Form:1
Age:2.0
Sex:Male
Location:Arkansas
Vaccinated:1992-07-09
Onset:1992-07-19
Submitted:1992-07-22
Entered:1992-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 322913 / 4 RA / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M695HK / 2 RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0144V / 1 LA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0652K / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Convulsion, Pyrexia, Rash

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: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': AR9243

Write-up: elevated temp & rash on neck starting 19JUL92 temp went to 105.8 had sz; hospitalized over noc; mom states WBC WNL; d/c 20JUL92 had DTP/OPV/HIB/MMR/TB Tine 9JUL92; MD felt related to vax;

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