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This is VAERS ID 96570

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 96570
VAERS Form:
Age:1.2
Sex:Female
Location:Arizona
Vaccinated:1997-02-26
Onset:1997-02-28
Submitted:1997-03-19
Entered:1997-04-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPH: TETRAMUNE / LEDERLE 440644 / 3 LL / IM
MMR: MMR II / MSD 1314B / 0 RA / SC

Administered by: Other      Purchased by: Unknown
Symptoms: VOMIT, SOMNOLENCE, INCONTIN URIN

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1997-03-03
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? No
Previous Vaccinations:
Other Medications:
Current Illness: fever, cough 2 days afeb 26FEB97
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: autopsy results pending;
CDC 'Split Type':

Write-up: pt began vomiting on 28FEB97 t/c to MD on call 2MAR97 711PM describes vomiting no diarrhea no blood in vomit;urinating, sleeping but easily arousable;advice given w/instructions to call back if sx inc & in AM for appointment;


Changed on 12/8/2009

VAERS ID: 96570 Before After
VAERS Form:
Age:1.2
Sex:Female
Location:Arizona
Vaccinated:1997-02-26
Onset:1997-02-28
Submitted:1997-03-19
Entered:1997-04-01 1997-03-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPH: TETRAMUNE / LEDERLE 440644 / 3 LL / IM
DTPHIB: DTP + HIB (TETRAMUNE) / LEDERLE LABORATORIES 440644 / 3 LL / IM
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 1314B / 0 RA / SC

Administered by: Other      Purchased by: Unknown Other
Symptoms: Somnolence, Urinary incontinence, Vomiting, VOMIT, SOMNOLENCE, INCONTIN URIN

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1997-03-03
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? No
Previous Vaccinations:
Other Medications:
Current Illness: fever, cough 2 days afeb 26FEB97
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: autopsy results pending;
CDC 'Split Type':

Write-up: pt began vomiting on 28FEB97 t/c to MD on call 2MAR97 711PM describes vomiting no diarrhea no blood in vomit;urinating, sleeping but easily arousable;advice given w/instructions to call back if sx inc & in AM for appointment;


Changed on 5/14/2017

VAERS ID: 96570 Before After
VAERS Form:
Age:1.2
Sex:Female
Location:Arizona
Vaccinated:1997-02-26
Onset:1997-02-28
Submitted:1997-03-19
Entered:1997-03-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPHIB: DTP + HIB (TETRAMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 440644 / 3 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1314B / 0 RA / SC

Administered by: Other      Purchased by: Other
Symptoms: Somnolence, Urinary incontinence, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1997-03-03
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: fever, cough 2 days afeb 26FEB97
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: autopsy results pending;
CDC 'Split Type':

Write-up: pt began vomiting on 28FEB97 t/c to MD on call 2MAR97 711PM describes vomiting no diarrhea no blood in vomit;urinating, sleeping but easily arousable;advice given w/instructions to call back if sx inc & in AM for appointment;


Changed on 9/14/2017

VAERS ID: 96570 Before After
VAERS Form:(blank) 1
Age:1.2
Sex:Female
Location:Arizona
Vaccinated:1997-02-26
Onset:1997-02-28
Submitted:1997-03-19
Entered:1997-03-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPHIB: DTP + HIB (TETRAMUNE) / PFIZER/WYETH 440644 / 3 4 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1314B / 0 1 RA / SC

Administered by: Other      Purchased by: Other
Symptoms: Somnolence, Urinary incontinence, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1997-03-03
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: fever, cough 2 days afeb 26FEB97
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: autopsy results pending;
CDC 'Split Type':

Write-up: pt began vomiting on 28FEB97 t/c to MD on call 2MAR97 711PM describes vomiting no diarrhea no blood in vomit;urinating, sleeping but easily arousable;advice given w/instructions to call back if sx inc & in AM for appointment;


Changed on 2/14/2018

VAERS ID: 96570 Before After
VAERS Form:1
Age:1.2
Sex:Female
Location:Arizona
Vaccinated:1997-02-26
Onset:1997-02-28
Submitted:1997-03-19
Entered:1997-03-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPHIB: DTP + HIB (TETRAMUNE) / PFIZER/WYETH 440644 / 4 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1314B / 1 RA / SC

Administered by: Other      Purchased by: Other
Symptoms: Somnolence, Urinary incontinence, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1997-03-03
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: fever, cough 2 days afeb 26FEB97
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: autopsy results pending;
CDC 'Split Type':

Write-up: pt began vomiting on 28FEB97 t/c to MD on call 2MAR97 711PM describes vomiting no diarrhea no blood in vomit;urinating, sleeping but easily arousable;advice given w/instructions to call back if sx inc & in AM for appointment;


Changed on 6/14/2018

VAERS ID: 96570 Before After
VAERS Form:1
Age:1.2
Sex:Female
Location:Arizona
Vaccinated:1997-02-26
Onset:1997-02-28
Submitted:1997-03-19
Entered:1997-03-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPHIB: DTP + HIB (TETRAMUNE) / PFIZER/WYETH 440644 / 4 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1314B / 1 RA / SC

Administered by: Other      Purchased by: Other
Symptoms: Somnolence, Urinary incontinence, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1997-03-03
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: fever, cough 2 days afeb 26FEB97
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: autopsy results pending;
CDC 'Split Type':

Write-up: pt began vomiting on 28FEB97 t/c to MD on call 2MAR97 711PM describes vomiting no diarrhea no blood in vomit;urinating, sleeping but easily arousable;advice given w/instructions to call back if sx inc & in AM for appointment;


Changed on 8/14/2018

VAERS ID: 96570 Before After
VAERS Form:1
Age:1.2
Sex:Female
Location:Arizona
Vaccinated:1997-02-26
Onset:1997-02-28
Submitted:1997-03-19
Entered:1997-03-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPHIB: DTP + HIB (TETRAMUNE) / PFIZER/WYETH 440644 / 4 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1314B / 1 RA / SC

Administered by: Other      Purchased by: Other
Symptoms: Somnolence, Urinary incontinence, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1997-03-03
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: fever, cough 2 days afeb 26FEB97
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: autopsy results pending;
CDC 'Split Type':

Write-up: pt began vomiting on 28FEB97 t/c to MD on call 2MAR97 711PM describes vomiting no diarrhea no blood in vomit;urinating, sleeping but easily arousable;advice given w/instructions to call back if sx inc & in AM for appointment;


Changed on 9/14/2018

VAERS ID: 96570 Before After
VAERS Form:1
Age:1.2
Sex:Female
Location:Arizona
Vaccinated:1997-02-26
Onset:1997-02-28
Submitted:1997-03-19
Entered:1997-03-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPHIB: DTP + HIB (TETRAMUNE) / PFIZER/WYETH 440644 / 4 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1314B / 1 RA / SC

Administered by: Other      Purchased by: Other
Symptoms: Somnolence, Urinary incontinence, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1997-03-03
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: fever, cough 2 days afeb 26FEB97
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: autopsy results pending;
CDC 'Split Type':

Write-up: pt began vomiting on 28FEB97 t/c to MD on call 2MAR97 711PM describes vomiting no diarrhea no blood in vomit;urinating, sleeping but easily arousable;advice given w/instructions to call back if sx inc & in AM for appointment;


Changed on 10/14/2018

VAERS ID: 96570 Before After
VAERS Form:1
Age:1.2
Sex:Female
Location:Arizona
Vaccinated:1997-02-26
Onset:1997-02-28
Submitted:1997-03-19
Entered:1997-03-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPHIB: DTP + HIB (TETRAMUNE) / PFIZER/WYETH 440644 / 4 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1314B / 1 RA / SC

Administered by: Other      Purchased by: Other
Symptoms: Somnolence, Urinary incontinence, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1997-03-03
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: fever, cough 2 days afeb 26FEB97
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: autopsy results pending;
CDC 'Split Type':

Write-up: pt began vomiting on 28FEB97 t/c to MD on call 2MAR97 711PM describes vomiting no diarrhea no blood in vomit;urinating, sleeping but easily arousable;advice given w/instructions to call back if sx inc & in AM for appointment;

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