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This is VAERS ID 47663

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 47663
VAERS Form:
Age:5.0
Sex:Female
Location:Mississippi
Vaccinated:1992-08-20
Onset:1992-08-31
Submitted:1992-09-30
Entered:1992-12-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 330910 / 4 LA / IM
MMR: MMR II / MSD 0011V / 1 RA / SC
OPV: ORIMUNE / LEDERLE 329960 / 3 - / PO

Administered by: Public      Purchased by: Unknown
Symptoms: CONVULS, FEVER, HEADACHE, PAIN NECK, COMA

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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? Yes
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: spinal tap, blood culture, EEG, x-rays, Brain scan;
CDC 'Split Type':

Write-up: 31AUG92 pt spiked t103 & c/o h/a & sore neck; was taken to hosp & treated w/PCN & phenergan & sent home; 1SEP92 pt had seizure & was taken to hosp adm to hosp 1SEP92; pt has been in coma since 1SEP92;


Changed on 12/8/2009

VAERS ID: 47663 Before After
VAERS Form:
Age:5.0
Sex:Female
Location:Mississippi
Vaccinated:1992-08-20
Onset:1992-08-31
Submitted:1992-09-30
Entered:1992-12-08 1992-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL DTP (TRI-IMMUNOL) / LEDERLE LEDERLE LABORATORIES 330910 / 4 LA / IM
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 0011V / 1 RA / SC
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES 329960 / 3 - / PO

Administered by: Public      Purchased by: Unknown Public
Symptoms: Coma, Convulsion, Headache, Neck pain, Pyrexia, CONVULS, FEVER, HEADACHE, PAIN NECK, COMA

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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? Yes
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: spinal tap, blood culture, EEG, x-rays, Brain scan;
CDC 'Split Type': (blank) MS9251

Write-up: 31AUG92 pt spiked t103 & c/o h/a & sore neck; was taken to hosp & treated w/PCN & phenergan & sent home; 1SEP92 pt had seizure & was taken to hosp adm to hosp 1SEP92; pt has been in coma since 1SEP92;


Changed on 5/14/2017

VAERS ID: 47663 Before After
VAERS Form:
Age:5.0
Sex:Female
Location:Mississippi
Vaccinated:1992-08-20
Onset:1992-08-31
Submitted:1992-09-30
Entered:1992-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 330910 / 4 LA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0011V / 1 RA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 329960 / 3 - / PO

Administered by: Public      Purchased by: Public
Symptoms: Coma, Convulsion, Headache, Neck pain, Pyrexia

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: spinal tap, blood culture, EEG, x-rays, Brain scan;
CDC 'Split Type': MS9251

Write-up: 31AUG92 pt spiked t103 & c/o h/a & sore neck; was taken to hosp & treated w/PCN & phenergan & sent home; 1SEP92 pt had seizure & was taken to hosp adm to hosp 1SEP92; pt has been in coma since 1SEP92;


Changed on 9/14/2017

VAERS ID: 47663 Before After
VAERS Form:(blank) 1
Age:5.0
Sex:Female
Location:Mississippi
Vaccinated:1992-08-20
Onset:1992-08-31
Submitted:1992-09-30
Entered:1992-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 330910 / 4 5 LA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0011V / 1 2 RA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 329960 / 3 4 - MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Coma, Convulsion, Headache, Neck pain, Pyrexia

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: spinal tap, blood culture, EEG, x-rays, Brain scan;
CDC 'Split Type': MS9251

Write-up: 31AUG92 pt spiked t103 & c/o h/a & sore neck; was taken to hosp & treated w/PCN & phenergan & sent home; 1SEP92 pt had seizure & was taken to hosp adm to hosp 1SEP92; pt has been in coma since 1SEP92;


Changed on 2/14/2018

VAERS ID: 47663 Before After
VAERS Form:1
Age:5.0
Sex:Female
Location:Mississippi
Vaccinated:1992-08-20
Onset:1992-08-31
Submitted:1992-09-30
Entered:1992-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 330910 / 5 LA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0011V / 2 RA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 329960 / 4 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Coma, Convulsion, Headache, Neck pain, Pyrexia

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: spinal tap, blood culture, EEG, x-rays, Brain scan;
CDC 'Split Type': MS9251

Write-up: 31AUG92 pt spiked t103 & c/o h/a & sore neck; was taken to hosp & treated w/PCN & phenergan & sent home; 1SEP92 pt had seizure & was taken to hosp adm to hosp 1SEP92; pt has been in coma since 1SEP92;


Changed on 6/14/2018

VAERS ID: 47663 Before After
VAERS Form:1
Age:5.0
Sex:Female
Location:Mississippi
Vaccinated:1992-08-20
Onset:1992-08-31
Submitted:1992-09-30
Entered:1992-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 330910 / 5 LA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0011V / 2 RA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 329960 / 4 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Coma, Convulsion, Headache, Neck pain, Pyrexia

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: spinal tap, blood culture, EEG, x-rays, Brain scan;
CDC 'Split Type': MS9251

Write-up: 31AUG92 pt spiked t103 & c/o h/a & sore neck; was taken to hosp & treated w/PCN & phenergan & sent home; 1SEP92 pt had seizure & was taken to hosp adm to hosp 1SEP92; pt has been in coma since 1SEP92;


Changed on 8/14/2018

VAERS ID: 47663 Before After
VAERS Form:1
Age:5.0
Sex:Female
Location:Mississippi
Vaccinated:1992-08-20
Onset:1992-08-31
Submitted:1992-09-30
Entered:1992-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 330910 / 5 LA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0011V / 2 RA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 329960 / 4 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Coma, Convulsion, Headache, Neck pain, Pyrexia

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: spinal tap, blood culture, EEG, x-rays, Brain scan;
CDC 'Split Type': MS9251

Write-up: 31AUG92 pt spiked t103 & c/o h/a & sore neck; was taken to hosp & treated w/PCN & phenergan & sent home; 1SEP92 pt had seizure & was taken to hosp adm to hosp 1SEP92; pt has been in coma since 1SEP92;


Changed on 9/14/2018

VAERS ID: 47663 Before After
VAERS Form:1
Age:5.0
Sex:Female
Location:Mississippi
Vaccinated:1992-08-20
Onset:1992-08-31
Submitted:1992-09-30
Entered:1992-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 330910 / 5 LA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0011V / 2 RA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 329960 / 4 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Coma, Convulsion, Headache, Neck pain, Pyrexia

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: spinal tap, blood culture, EEG, x-rays, Brain scan;
CDC 'Split Type': MS9251

Write-up: 31AUG92 pt spiked t103 & c/o h/a & sore neck; was taken to hosp & treated w/PCN & phenergan & sent home; 1SEP92 pt had seizure & was taken to hosp adm to hosp 1SEP92; pt has been in coma since 1SEP92;


Changed on 10/14/2018

VAERS ID: 47663 Before After
VAERS Form:1
Age:5.0
Sex:Female
Location:Mississippi
Vaccinated:1992-08-20
Onset:1992-08-31
Submitted:1992-09-30
Entered:1992-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 330910 / 5 LA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0011V / 2 RA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 329960 / 4 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Coma, Convulsion, Headache, Neck pain, Pyrexia

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: spinal tap, blood culture, EEG, x-rays, Brain scan;
CDC 'Split Type': MS9251

Write-up: 31AUG92 pt spiked t103 & c/o h/a & sore neck; was taken to hosp & treated w/PCN & phenergan & sent home; 1SEP92 pt had seizure & was taken to hosp adm to hosp 1SEP92; pt has been in coma since 1SEP92;

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