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This is VAERS ID 47460

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 47460
VAERS Form:
Age:1.8
Sex:Male
Location:Montana
Vaccinated:1992-10-13
Onset:1992-10-27
Submitted:1992-11-10
Entered:1992-12-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 322915 / 3 RL / IM
MMR: MMR II / MSD 0055T / 0 LL / IM
OPV: ORIMUNE / LEDERLE 0652K / 2 - / PO

Administered by: Public      Purchased by: Unknown
Symptoms: INFECT, DYSPNEA, MENINGITIS, PNEUMONIA

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-10-27
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: URI-no temp
Preexisting Conditions: normal
Allergies:
Diagnostic Lab Data: lab tests completed @ hosp 27OCT92;
CDC 'Split Type': normal

Write-up: pt was admitted to hosp on 27OCT92 for pneumonia began to devel resp problems & was transferred to another hosp on 27OCT92; dx Haemophilus Influenza meningitis & died 27OCT92;


Changed on 12/8/2009

VAERS ID: 47460 Before After
VAERS Form:
Age:1.8
Sex:Male
Location:Montana
Vaccinated:1992-10-13
Onset:1992-10-27
Submitted:1992-11-10
Entered:1992-12-01 1992-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL DTP (TRI-IMMUNOL) / LEDERLE LEDERLE LABORATORIES 322915 / 3 RL / IM
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 0055T / 0 LL / IM
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES 0652K / 2 - / PO

Administered by: Public      Purchased by: Unknown Public
Symptoms: Dyspnoea, Infection, Meningitis, Pneumonia, INFECT, DYSPNEA, MENINGITIS, PNEUMONIA

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-10-27
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: URI-no temp
Preexisting Conditions: normal
Allergies:
Diagnostic Lab Data: lab tests completed @ hosp 27OCT92;
CDC 'Split Type': normal MT92027

Write-up: pt was admitted to hosp on 27OCT92 for pneumonia began to devel resp problems & was transferred to another hosp on 27OCT92; dx Haemophilus Influenza meningitis & died 27OCT92;


Changed on 5/14/2017

VAERS ID: 47460 Before After
VAERS Form:
Age:1.8
Sex:Male
Location:Montana
Vaccinated:1992-10-13
Onset:1992-10-27
Submitted:1992-11-10
Entered:1992-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 322915 / 3 RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0055T / 0 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 0652K / 2 - / PO

Administered by: Public      Purchased by: Public
Symptoms: Dyspnoea, Infection, Meningitis, Pneumonia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-10-27
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: NONE NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: URI-no temp
Preexisting Conditions: normal
Allergies:
Diagnostic Lab Data: lab tests completed @ hosp 27OCT92;
CDC 'Split Type': MT92027

Write-up: pt was admitted to hosp on 27OCT92 for pneumonia began to devel resp problems & was transferred to another hosp on 27OCT92; dx Haemophilus Influenza meningitis & died 27OCT92;


Changed on 9/14/2017

VAERS ID: 47460 Before After
VAERS Form:(blank) 1
Age:1.8
Sex:Male
Location:Montana
Vaccinated:1992-10-13
Onset:1992-10-27
Submitted:1992-11-10
Entered:1992-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 322915 / 3 4 RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0055T / 0 1 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0652K / 2 3 - MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Dyspnoea, Infection, Meningitis, Pneumonia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-10-27
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: URI-no temp
Preexisting Conditions: normal
Allergies:
Diagnostic Lab Data: lab tests completed @ hosp 27OCT92;
CDC 'Split Type': MT92027

Write-up: pt was admitted to hosp on 27OCT92 for pneumonia began to devel resp problems & was transferred to another hosp on 27OCT92; dx Haemophilus Influenza meningitis & died 27OCT92;


Changed on 2/14/2018

VAERS ID: 47460 Before After
VAERS Form:1
Age:1.8
Sex:Male
Location:Montana
Vaccinated:1992-10-13
Onset:1992-10-27
Submitted:1992-11-10
Entered:1992-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 322915 / 4 RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0055T / 1 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0652K / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Dyspnoea, Infection, Meningitis, Pneumonia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-10-27
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: URI-no temp
Preexisting Conditions: normal
Allergies:
Diagnostic Lab Data: lab tests completed @ hosp 27OCT92;
CDC 'Split Type': MT92027

Write-up: pt was admitted to hosp on 27OCT92 for pneumonia began to devel resp problems & was transferred to another hosp on 27OCT92; dx Haemophilus Influenza meningitis & died 27OCT92;


Changed on 6/14/2018

VAERS ID: 47460 Before After
VAERS Form:1
Age:1.8
Sex:Male
Location:Montana
Vaccinated:1992-10-13
Onset:1992-10-27
Submitted:1992-11-10
Entered:1992-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 322915 / 4 RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0055T / 1 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0652K / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Dyspnoea, Infection, Meningitis, Pneumonia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-10-27
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: URI-no temp
Preexisting Conditions: normal
Allergies:
Diagnostic Lab Data: lab tests completed @ hosp 27OCT92;
CDC 'Split Type': MT92027

Write-up: pt was admitted to hosp on 27OCT92 for pneumonia began to devel resp problems & was transferred to another hosp on 27OCT92; dx Haemophilus Influenza meningitis & died 27OCT92;


Changed on 8/14/2018

VAERS ID: 47460 Before After
VAERS Form:1
Age:1.8
Sex:Male
Location:Montana
Vaccinated:1992-10-13
Onset:1992-10-27
Submitted:1992-11-10
Entered:1992-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 322915 / 4 RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0055T / 1 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0652K / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Dyspnoea, Infection, Meningitis, Pneumonia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-10-27
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: URI-no temp
Preexisting Conditions: normal
Allergies:
Diagnostic Lab Data: lab tests completed @ hosp 27OCT92;
CDC 'Split Type': MT92027

Write-up: pt was admitted to hosp on 27OCT92 for pneumonia began to devel resp problems & was transferred to another hosp on 27OCT92; dx Haemophilus Influenza meningitis & died 27OCT92;


Changed on 9/14/2018

VAERS ID: 47460 Before After
VAERS Form:1
Age:1.8
Sex:Male
Location:Montana
Vaccinated:1992-10-13
Onset:1992-10-27
Submitted:1992-11-10
Entered:1992-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 322915 / 4 RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0055T / 1 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0652K / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Dyspnoea, Infection, Meningitis, Pneumonia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-10-27
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: URI-no temp
Preexisting Conditions: normal
Allergies:
Diagnostic Lab Data: lab tests completed @ hosp 27OCT92;
CDC 'Split Type': MT92027

Write-up: pt was admitted to hosp on 27OCT92 for pneumonia began to devel resp problems & was transferred to another hosp on 27OCT92; dx Haemophilus Influenza meningitis & died 27OCT92;


Changed on 10/14/2018

VAERS ID: 47460 Before After
VAERS Form:1
Age:1.8
Sex:Male
Location:Montana
Vaccinated:1992-10-13
Onset:1992-10-27
Submitted:1992-11-10
Entered:1992-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 322915 / 4 RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0055T / 1 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0652K / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Dyspnoea, Infection, Meningitis, Pneumonia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-10-27
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: URI-no temp
Preexisting Conditions: normal
Allergies:
Diagnostic Lab Data: lab tests completed @ hosp 27OCT92;
CDC 'Split Type': MT92027

Write-up: pt was admitted to hosp on 27OCT92 for pneumonia began to devel resp problems & was transferred to another hosp on 27OCT92; dx Haemophilus Influenza meningitis & died 27OCT92;

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