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This is VAERS ID 245395

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 245395
VAERS Form:
Age:1.7
Sex:Female
Location:Florida
Vaccinated:2005-08-26
Onset:0000-00-00
Submitted:2005-10-12
Entered:2005-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / AVENTIS PASTEUR, C2253AA / - LL / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: FEVER, MALAISE, NERVOUSNESS, AUTISM, ANOMALY CONGEN MS

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: fever, crying, listlessness;Measles + Mumps + Rubella (Unknown Mfr);;1;In Patient
Other Medications:
Current Illness:
Preexisting Conditions: Pt''s mom states that her daughter had 3 doses of Tripedia at ages 2, 4 and 6 months. She showed signs of Autism at 7 months of age. At 12 months they had her hearing checked because she was ignoring her mom and dad. The pt''s hearing is good
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': Pt''s mom states that her daughter had 3 doses of Tripedia at ages 2, 4 and 6 months. She showed signs of Autism at 7 months of age. At 12 months they had her hearing checked because she was ignoring her mom and dad. The pt''s hearing is good

Write-up: Initial report received from a consumer on 04Oct05. A mother reported that her 22 month old daughter had inconsolable crying (1/2 hr episodes at a time), showed signs of being easily frustrated, began spinning in circles, had facial contortions, showed ha"nd gesturing and was patting herself on the chest, four days after receiving the intra muscular injection of Daptacel (dose four) lot number C2253AA in the left thigh on 26Aug05. The pt received in concomitant the IM injection of Prevnar lot number A94451


Changed on 12/8/2009

VAERS ID: 245395 Before After
VAERS Form:
Age:1.7
Sex:Female
Location:Florida
Vaccinated:2005-08-26
Onset:0000-00-00
Submitted:2005-10-12
Entered:2005-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / AVENTIS PASTEUR, AVENTIS PASTEUR C2253AA / - LL / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Autism, Facial dysmorphism, Irritability, Listless, Pyrexia, Screaming, Abnormal behaviour, FEVER, MALAISE, NERVOUSNESS, AUTISM, ANOMALY CONGEN MS

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: fever, crying, listlessness;Measles listlessness~Measles + Mumps + Rubella (Unknown Mfr);;1;In (unknown mfr)~~1~In Patient
Other Medications:
Current Illness:
Preexisting Conditions: Pt''s mom states that her daughter had 3 doses of Tripedia at ages 2, 4 and 6 months. She showed signs of Autism at 7 months of age. At 12 months they had her hearing checked because she was ignoring her mom and dad. The pt''s hearing is good good. Pt received MMR dose one at 12 months of age and experienced crying, fever and listlessness which was never reported.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': Pt''s mom states that her daughter had 3 doses of Tripedia at ages 2, 4 and 6 months. She showed signs of Autism at 7 months of age. At 12 months they had her hearing checked because she was ignoring her mom and dad. The pt''s hearing is good 200501988

Write-up: Initial report received from a consumer on 04Oct05. A mother reported that her 22 month old daughter had inconsolable crying (1/2 hr episodes at a time), showed signs of being easily frustrated, began spinning in circles, had facial contortions, showed ha"nd hand gesturing and was patting herself on the chest, four days after receiving the intra muscular injection of Daptacel (dose four) lot number C2253AA in the left thigh on 26Aug05. The pt received in concomitant the IM injection of Prevnar lot number A94451 A94451K in the left thigh. Pt''s mom states that her daughter had 3 doses of Tripedia at ages 2, 4 and 6 months. Dates of administration not reported. She showed signs of Autism at 7 months of age. At 12 months they had her hearing checked because she was ignoring her mom and dad. The pt''s hearing was good. Pt received MMR dose one at 12 months of age and experienced crying, fever and listlessness which was never reported. Mom stated they are working with a neurologist to prove autism. No further information was provided by the reporter.


Changed on 2/14/2017

VAERS ID: 245395 Before After
VAERS Form:
Age:1.7 1.73
Sex:Female
Location:Florida
Vaccinated:2005-08-26
Onset:0000-00-00
Submitted:2005-10-12
Entered:2005-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / AVENTIS PASTEUR C2253AA / - LL / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Autism, Facial dysmorphism, Irritability, Listless, Pyrexia, Screaming, Abnormal behaviour

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: fever, crying, listlessness~Measles + Mumps + Rubella (unknown mfr)~~1~In Patient
Other Medications:
Current Illness:
Preexisting Conditions: Pt''s mom states that her daughter had 3 doses of Tripedia at ages 2, 4 and 6 months. She showed signs of Autism at 7 months of age. At 12 months they had her hearing checked because she was ignoring her mom and dad. The pt''s hearing is good. Pt received MMR dose one at 12 months of age and experienced crying, fever and listlessness which was never reported.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 200501988

Write-up: Initial report received from a consumer on 04Oct05. A mother reported that her 22 month old daughter had inconsolable crying (1/2 hr episodes at a time), showed signs of being easily frustrated, began spinning in circles, had facial contortions, showed hand gesturing and was patting herself on the chest, four days after receiving the intra muscular injection of Daptacel (dose four) lot number C2253AA in the left thigh on 26Aug05. The pt received in concomitant the IM injection of Prevnar lot number A94451K in the left thigh. Pt''s mom states that her daughter had 3 doses of Tripedia at ages 2, 4 and 6 months. Dates of administration not reported. She showed signs of Autism at 7 months of age. At 12 months they had her hearing checked because she was ignoring her mom and dad. The pt''s hearing was good. Pt received MMR dose one at 12 months of age and experienced crying, fever and listlessness which was never reported. Mom stated they are working with a neurologist to prove autism. No further information was provided by the reporter.


Changed on 5/14/2017

VAERS ID: 245395 Before After
VAERS Form:
Age:1.73
Sex:Female
Location:Florida
Vaccinated:2005-08-26
Onset:0000-00-00
Submitted:2005-10-12
Entered:2005-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / AVENTIS PASTEUR SANOFI PASTEUR C2253AA / - LL / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Autism, Crying, Facial dysmorphism, Irritability, Listless, Pyrexia, Screaming, Abnormal behaviour

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: fever, crying, listlessness~Measles + Mumps + Rubella (unknown mfr)~~1~In (no brand name)~~1.00~In Patient
Other Medications:
Current Illness:
Preexisting Conditions: Pt''s mom states that her daughter had 3 doses of Tripedia at ages 2, 4 and 6 months. She showed signs of Autism at 7 months of age. At 12 months they had her hearing checked because she was ignoring her mom and dad. The pt''s hearing is good. Pt received MMR dose one at 12 months of age and experienced crying, fever and listlessness which was never reported.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 200501988

Write-up: Initial report received from a consumer on 04Oct05. A mother reported that her 22 month old daughter had inconsolable crying (1/2 hr episodes at a time), showed signs of being easily frustrated, began spinning in circles, had facial contortions, showed hand gesturing and was patting herself on the chest, four days after receiving the intra muscular injection of Daptacel (dose four) lot number C2253AA in the left thigh on 26Aug05. The pt received in concomitant the IM injection of Prevnar lot number A94451K in the left thigh. Pt''s mom states that her daughter had 3 doses of Tripedia at ages 2, 4 and 6 months. Dates of administration not reported. She showed signs of Autism at 7 months of age. At 12 months they had her hearing checked because she was ignoring her mom and dad. The pt''s hearing was good. Pt received MMR dose one at 12 months of age and experienced crying, fever and listlessness which was never reported. Mom stated they are working with a neurologist to prove autism. No further information was provided by the reporter.


Changed on 9/14/2017

VAERS ID: 245395 Before After
VAERS Form:(blank) 1
Age:1.73
Sex:Female
Location:Florida
Vaccinated:2005-08-26
Onset:0000-00-00
Submitted:2005-10-12
Entered:2005-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2253AA / - UNK LL / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Autism, Crying, Facial dysmorphism, Irritability, Listless, Pyrexia, Screaming, Abnormal behaviour

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: fever, crying, listlessness~Measles + Mumps + Rubella (no brand name)~~1.00~In Patient
Other Medications:
Current Illness:
Preexisting Conditions: Pt''s mom states that her daughter had 3 doses of Tripedia at ages 2, 4 and 6 months. She showed signs of Autism at 7 months of age. At 12 months they had her hearing checked because she was ignoring her mom and dad. The pt''s hearing is good. Pt received MMR dose one at 12 months of age and experienced crying, fever and listlessness which was never reported.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 200501988

Write-up: Initial report received from a consumer on 04Oct05. A mother reported that her 22 month old daughter had inconsolable crying (1/2 hr episodes at a time), showed signs of being easily frustrated, began spinning in circles, had facial contortions, showed hand gesturing and was patting herself on the chest, four days after receiving the intra muscular injection of Daptacel (dose four) lot number C2253AA in the left thigh on 26Aug05. The pt received in concomitant the IM injection of Prevnar lot number A94451K in the left thigh. Pt''s mom states that her daughter had 3 doses of Tripedia at ages 2, 4 and 6 months. Dates of administration not reported. She showed signs of Autism at 7 months of age. At 12 months they had her hearing checked because she was ignoring her mom and dad. The pt''s hearing was good. Pt received MMR dose one at 12 months of age and experienced crying, fever and listlessness which was never reported. Mom stated they are working with a neurologist to prove autism. No further information was provided by the reporter.


Changed on 2/14/2018

VAERS ID: 245395 Before After
VAERS Form:1
Age:1.73
Sex:Female
Location:Florida
Vaccinated:2005-08-26
Onset:0000-00-00
Submitted:2005-10-12
Entered:2005-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2253AA / UNK LL / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Autism, Crying, Facial dysmorphism, Irritability, Listless, Pyrexia, Screaming, Abnormal behaviour

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: fever, crying, listlessness~Measles + Mumps + Rubella (no brand name)~~1.00~In Patient
Other Medications:
Current Illness:
Preexisting Conditions: Pt''s mom states that her daughter had 3 doses of Tripedia at ages 2, 4 and 6 months. She showed signs of Autism at 7 months of age. At 12 months they had her hearing checked because she was ignoring her mom and dad. The pt''s hearing is good. Pt received MMR dose one at 12 months of age and experienced crying, fever and listlessness which was never reported.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 200501988

Write-up: Initial report received from a consumer on 04Oct05. A mother reported that her 22 month old daughter had inconsolable crying (1/2 hr episodes at a time), showed signs of being easily frustrated, began spinning in circles, had facial contortions, showed hand gesturing and was patting herself on the chest, four days after receiving the intra muscular injection of Daptacel (dose four) lot number C2253AA in the left thigh on 26Aug05. The pt received in concomitant the IM injection of Prevnar lot number A94451K in the left thigh. Pt''s mom states that her daughter had 3 doses of Tripedia at ages 2, 4 and 6 months. Dates of administration not reported. She showed signs of Autism at 7 months of age. At 12 months they had her hearing checked because she was ignoring her mom and dad. The pt''s hearing was good. Pt received MMR dose one at 12 months of age and experienced crying, fever and listlessness which was never reported. Mom stated they are working with a neurologist to prove autism. No further information was provided by the reporter.


Changed on 6/14/2018

VAERS ID: 245395 Before After
VAERS Form:1
Age:1.73
Sex:Female
Location:Florida
Vaccinated:2005-08-26
Onset:0000-00-00
Submitted:2005-10-12
Entered:2005-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2253AA / UNK LL / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Autism, Crying, Facial dysmorphism, Irritability, Listless, Pyrexia, Screaming, Abnormal behaviour

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: fever, crying, listlessness~Measles + Mumps + Rubella (no brand name)~~1.00~In Patient
Other Medications:
Current Illness:
Preexisting Conditions: Pt''s mom states that her daughter had 3 doses of Tripedia at ages 2, 4 and 6 months. She showed signs of Autism at 7 months of age. At 12 months they had her hearing checked because she was ignoring her mom and dad. The pt''s hearing is good. Pt received MMR dose one at 12 months of age and experienced crying, fever and listlessness which was never reported.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 200501988

Write-up: Initial report received from a consumer on 04Oct05. A mother reported that her 22 month old daughter had inconsolable crying (1/2 hr episodes at a time), showed signs of being easily frustrated, began spinning in circles, had facial contortions, showed hand gesturing and was patting herself on the chest, four days after receiving the intra muscular injection of Daptacel (dose four) lot number C2253AA in the left thigh on 26Aug05. The pt received in concomitant the IM injection of Prevnar lot number A94451K in the left thigh. Pt''s mom states that her daughter had 3 doses of Tripedia at ages 2, 4 and 6 months. Dates of administration not reported. She showed signs of Autism at 7 months of age. At 12 months they had her hearing checked because she was ignoring her mom and dad. The pt''s hearing was good. Pt received MMR dose one at 12 months of age and experienced crying, fever and listlessness which was never reported. Mom stated they are working with a neurologist to prove autism. No further information was provided by the reporter.


Changed on 8/14/2018

VAERS ID: 245395 Before After
VAERS Form:1
Age:1.73
Sex:Female
Location:Florida
Vaccinated:2005-08-26
Onset:0000-00-00
Submitted:2005-10-12
Entered:2005-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2253AA / UNK LL / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Autism, Crying, Facial dysmorphism, Irritability, Listless, Pyrexia, Screaming, Abnormal behaviour

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: fever, crying, listlessness~Measles + Mumps + Rubella (no brand name)~~1.00~In Patient
Other Medications:
Current Illness:
Preexisting Conditions: Pt''s mom states that her daughter had 3 doses of Tripedia at ages 2, 4 and 6 months. She showed signs of Autism at 7 months of age. At 12 months they had her hearing checked because she was ignoring her mom and dad. The pt''s hearing is good. Pt received MMR dose one at 12 months of age and experienced crying, fever and listlessness which was never reported.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 200501988

Write-up: Initial report received from a consumer on 04Oct05. A mother reported that her 22 month old daughter had inconsolable crying (1/2 hr episodes at a time), showed signs of being easily frustrated, began spinning in circles, had facial contortions, showed hand gesturing and was patting herself on the chest, four days after receiving the intra muscular injection of Daptacel (dose four) lot number C2253AA in the left thigh on 26Aug05. The pt received in concomitant the IM injection of Prevnar lot number A94451K in the left thigh. Pt''s mom states that her daughter had 3 doses of Tripedia at ages 2, 4 and 6 months. Dates of administration not reported. She showed signs of Autism at 7 months of age. At 12 months they had her hearing checked because she was ignoring her mom and dad. The pt''s hearing was good. Pt received MMR dose one at 12 months of age and experienced crying, fever and listlessness which was never reported. Mom stated they are working with a neurologist to prove autism. No further information was provided by the reporter.


Changed on 9/14/2018

VAERS ID: 245395 Before After
VAERS Form:1
Age:1.73
Sex:Female
Location:Florida
Vaccinated:2005-08-26
Onset:0000-00-00
Submitted:2005-10-12
Entered:2005-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2253AA / UNK LL / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Autism, Crying, Facial dysmorphism, Irritability, Listless, Pyrexia, Screaming, Abnormal behaviour

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: fever, crying, listlessness~Measles + Mumps + Rubella (no brand name)~~1.00~In Patient
Other Medications:
Current Illness:
Preexisting Conditions: Pt''s mom states that her daughter had 3 doses of Tripedia at ages 2, 4 and 6 months. She showed signs of Autism at 7 months of age. At 12 months they had her hearing checked because she was ignoring her mom and dad. The pt''s hearing is good. Pt received MMR dose one at 12 months of age and experienced crying, fever and listlessness which was never reported.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 200501988

Write-up: Initial report received from a consumer on 04Oct05. A mother reported that her 22 month old daughter had inconsolable crying (1/2 hr episodes at a time), showed signs of being easily frustrated, began spinning in circles, had facial contortions, showed hand gesturing and was patting herself on the chest, four days after receiving the intra muscular injection of Daptacel (dose four) lot number C2253AA in the left thigh on 26Aug05. The pt received in concomitant the IM injection of Prevnar lot number A94451K in the left thigh. Pt''s mom states that her daughter had 3 doses of Tripedia at ages 2, 4 and 6 months. Dates of administration not reported. She showed signs of Autism at 7 months of age. At 12 months they had her hearing checked because she was ignoring her mom and dad. The pt''s hearing was good. Pt received MMR dose one at 12 months of age and experienced crying, fever and listlessness which was never reported. Mom stated they are working with a neurologist to prove autism. No further information was provided by the reporter.


Changed on 10/14/2018

VAERS ID: 245395 Before After
VAERS Form:1
Age:1.73
Sex:Female
Location:Florida
Vaccinated:2005-08-26
Onset:0000-00-00
Submitted:2005-10-12
Entered:2005-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2253AA / UNK LL / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Autism, Crying, Facial dysmorphism, Irritability, Listless, Pyrexia, Screaming, Abnormal behaviour

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: fever, crying, listlessness~Measles + Mumps + Rubella (no brand name)~~1.00~In Patient
Other Medications:
Current Illness:
Preexisting Conditions: Pt''s mom states that her daughter had 3 doses of Tripedia at ages 2, 4 and 6 months. She showed signs of Autism at 7 months of age. At 12 months they had her hearing checked because she was ignoring her mom and dad. The pt''s hearing is good. Pt received MMR dose one at 12 months of age and experienced crying, fever and listlessness which was never reported.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 200501988

Write-up: Initial report received from a consumer on 04Oct05. A mother reported that her 22 month old daughter had inconsolable crying (1/2 hr episodes at a time), showed signs of being easily frustrated, began spinning in circles, had facial contortions, showed hand gesturing and was patting herself on the chest, four days after receiving the intra muscular injection of Daptacel (dose four) lot number C2253AA in the left thigh on 26Aug05. The pt received in concomitant the IM injection of Prevnar lot number A94451K in the left thigh. Pt''s mom states that her daughter had 3 doses of Tripedia at ages 2, 4 and 6 months. Dates of administration not reported. She showed signs of Autism at 7 months of age. At 12 months they had her hearing checked because she was ignoring her mom and dad. The pt''s hearing was good. Pt received MMR dose one at 12 months of age and experienced crying, fever and listlessness which was never reported. Mom stated they are working with a neurologist to prove autism. No further information was provided by the reporter.


Changed on 12/24/2020

VAERS ID: 245395 Before After
VAERS Form:1
Age:1.73
Sex:Female
Location:Florida
Vaccinated:2005-08-26
Onset:0000-00-00
Submitted:2005-10-12
Entered:2005-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2253AA / UNK LL / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Autism, Crying, Facial dysmorphism, Irritability, Listless, Pyrexia, Screaming, Abnormal behaviour

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: fever, crying, listlessness~Measles + Mumps + Rubella (no brand name)~~1.00~In Patient
Other Medications:
Current Illness:
Preexisting Conditions: Pt''s mom states that her daughter had 3 doses of Tripedia at ages 2, 4 and 6 months. She showed signs of Autism at 7 months of age. At 12 months they had her hearing checked because she was ignoring her mom and dad. The pt''s hearing is good. Pt received MMR dose one at 12 months of age and experienced crying, fever and listlessness which was never reported.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 200501988

Write-up: Initial report received from a consumer on 04Oct05. A mother reported that her 22 month old daughter had inconsolable crying (1/2 hr episodes at a time), showed signs of being easily frustrated, began spinning in circles, had facial contortions, showed hand gesturing and was patting herself on the chest, four days after receiving the intra muscular injection of Daptacel (dose four) lot number C2253AA in the left thigh on 26Aug05. The pt received in concomitant the IM injection of Prevnar lot number A94451K in the left thigh. Pt''s mom states that her daughter had 3 doses of Tripedia at ages 2, 4 and 6 months. Dates of administration not reported. She showed signs of Autism at 7 months of age. At 12 months they had her hearing checked because she was ignoring her mom and dad. The pt''s hearing was good. Pt received MMR dose one at 12 months of age and experienced crying, fever and listlessness which was never reported. Mom stated they are working with a neurologist to prove autism. No further information was provided by the reporter.


Changed on 12/30/2020

VAERS ID: 245395 Before After
VAERS Form:1
Age:1.73
Sex:Female
Location:Florida
Vaccinated:2005-08-26
Onset:0000-00-00
Submitted:2005-10-12
Entered:2005-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2253AA / UNK LL / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Autism, Crying, Facial dysmorphism, Irritability, Listless, Pyrexia, Screaming, Abnormal behaviour

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: fever, crying, listlessness~Measles + Mumps + Rubella (no brand name)~~1.00~In Patient
Other Medications:
Current Illness:
Preexisting Conditions: Pt''s mom states that her daughter had 3 doses of Tripedia at ages 2, 4 and 6 months. She showed signs of Autism at 7 months of age. At 12 months they had her hearing checked because she was ignoring her mom and dad. The pt''s hearing is good. Pt received MMR dose one at 12 months of age and experienced crying, fever and listlessness which was never reported.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 200501988

Write-up: Initial report received from a consumer on 04Oct05. A mother reported that her 22 month old daughter had inconsolable crying (1/2 hr episodes at a time), showed signs of being easily frustrated, began spinning in circles, had facial contortions, showed hand gesturing and was patting herself on the chest, four days after receiving the intra muscular injection of Daptacel (dose four) lot number C2253AA in the left thigh on 26Aug05. The pt received in concomitant the IM injection of Prevnar lot number A94451K in the left thigh. Pt''s mom states that her daughter had 3 doses of Tripedia at ages 2, 4 and 6 months. Dates of administration not reported. She showed signs of Autism at 7 months of age. At 12 months they had her hearing checked because she was ignoring her mom and dad. The pt''s hearing was good. Pt received MMR dose one at 12 months of age and experienced crying, fever and listlessness which was never reported. Mom stated they are working with a neurologist to prove autism. No further information was provided by the reporter.


Changed on 5/7/2021

VAERS ID: 245395 Before After
VAERS Form:1
Age:1.73
Sex:Female
Location:Florida
Vaccinated:2005-08-26
Onset:0000-00-00
Submitted:2005-10-12
Entered:2005-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2253AA / UNK LL / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Autism, Crying, Facial dysmorphism, Irritability, Listless, Pyrexia, Screaming, Abnormal behaviour

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: fever, crying, listlessness~Measles + Mumps + Rubella (no brand name)~~1.00~In Patient
Other Medications:
Current Illness:
Preexisting Conditions: Pt''s mom states that her daughter had 3 doses of Tripedia at ages 2, 4 and 6 months. She showed signs of Autism at 7 months of age. At 12 months they had her hearing checked because she was ignoring her mom and dad. The pt''s hearing is good. Pt received MMR dose one at 12 months of age and experienced crying, fever and listlessness which was never reported.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 200501988

Write-up: Initial report received from a consumer on 04Oct05. A mother reported that her 22 month old daughter had inconsolable crying (1/2 hr episodes at a time), showed signs of being easily frustrated, began spinning in circles, had facial contortions, showed hand gesturing and was patting herself on the chest, four days after receiving the intra muscular injection of Daptacel (dose four) lot number C2253AA in the left thigh on 26Aug05. The pt received in concomitant the IM injection of Prevnar lot number A94451K in the left thigh. Pt''s mom states that her daughter had 3 doses of Tripedia at ages 2, 4 and 6 months. Dates of administration not reported. She showed signs of Autism at 7 months of age. At 12 months they had her hearing checked because she was ignoring her mom and dad. The pt''s hearing was good. Pt received MMR dose one at 12 months of age and experienced crying, fever and listlessness which was never reported. Mom stated they are working with a neurologist to prove autism. No further information was provided by the reporter.


Changed on 5/14/2021

VAERS ID: 245395 Before After
VAERS Form:1
Age:1.73
Sex:Female
Location:Florida
Vaccinated:2005-08-26
Onset:0000-00-00
Submitted:2005-10-12
Entered:2005-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2253AA / UNK LL / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Autism, Crying, Facial dysmorphism, Irritability, Listless, Pyrexia, Screaming, Abnormal behaviour

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: fever, crying, listlessness~Measles + Mumps + Rubella (no brand name)~~1.00~In Patient
Other Medications:
Current Illness:
Preexisting Conditions: Pt''s mom states that her daughter had 3 doses of Tripedia at ages 2, 4 and 6 months. She showed signs of Autism at 7 months of age. At 12 months they had her hearing checked because she was ignoring her mom and dad. The pt''s hearing is good. Pt received MMR dose one at 12 months of age and experienced crying, fever and listlessness which was never reported.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 200501988

Write-up: Initial report received from a consumer on 04Oct05. A mother reported that her 22 month old daughter had inconsolable crying (1/2 hr episodes at a time), showed signs of being easily frustrated, began spinning in circles, had facial contortions, showed hand gesturing and was patting herself on the chest, four days after receiving the intra muscular injection of Daptacel (dose four) lot number C2253AA in the left thigh on 26Aug05. The pt received in concomitant the IM injection of Prevnar lot number A94451K in the left thigh. Pt''s mom states that her daughter had 3 doses of Tripedia at ages 2, 4 and 6 months. Dates of administration not reported. She showed signs of Autism at 7 months of age. At 12 months they had her hearing checked because she was ignoring her mom and dad. The pt''s hearing was good. Pt received MMR dose one at 12 months of age and experienced crying, fever and listlessness which was never reported. Mom stated they are working with a neurologist to prove autism. No further information was provided by the reporter.

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