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This is VAERS ID 25051

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History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 25051
VAERS Form:
Age:5.2
Sex:Male
Location:California
Vaccinated:1990-05-04
Onset:1990-05-05
Submitted:0000-00-00
Entered:1990-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP / CONNAUGHT LABS 0B11038 / 4 RL / IM

Administered by: Military      Purchased by: Unknown
Symptoms: INJECT SITE REACT, FEVER

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:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: fever, inject site reaction, swelling in right thigh


Changed on 12/8/2009

VAERS ID: 25051 Before After
VAERS Form:
Age:5.2
Sex:Male
Location:California
Vaccinated:1990-05-04
Onset:1990-05-05
Submitted:0000-00-00
Entered:1990-07-11 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP DTP (NO BRAND NAME) / CONNAUGHT LABS CONNAUGHT LABORATORIES 0B11038 / 4 RL / IM

Administered by: Military      Purchased by: Unknown
Symptoms: Injection site reaction, Pyrexia, INJECT SITE REACT, FEVER

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:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: fever, inject site reaction, swelling in right thigh


Changed on 2/14/2017

VAERS ID: 25051 Before After
VAERS Form:
Age:5.2 5.0
Sex:Male
Location:California
Vaccinated:1990-05-04
Onset:1990-05-05
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0B11038 / 4 RL / IM

Administered by: Military      Purchased by: Unknown
Symptoms: Injection site reaction, Pyrexia

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:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: fever, inject site reaction, swelling in right thigh


Changed on 5/14/2017

VAERS ID: 25051 Before After
VAERS Form:
Age:5.0
Sex:Male
Location:California
Vaccinated:1990-05-04
Onset:1990-05-05
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0B11038 / 4 RL / IM

Administered by: Military      Purchased by: Unknown
Symptoms: Injection site reaction, Pyrexia

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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: fever, inject site reaction, swelling in right thigh


Changed on 9/14/2017

VAERS ID: 25051 Before After
VAERS Form:(blank) 1
Age:5.0
Sex:Male
Location:California
Vaccinated:1990-05-04
Onset:1990-05-05
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0B11038 / 4 5 RL / IM

Administered by: Military      Purchased by: Unknown
Symptoms: Injection site reaction, Pyrexia

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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: fever, inject site reaction, swelling in right thigh


Changed on 2/14/2018

VAERS ID: 25051 Before After
VAERS Form:1
Age:5.0
Sex:Male
Location:California
Vaccinated:1990-05-04
Onset:1990-05-05
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0B11038 / 5 RL / IM

Administered by: Military      Purchased by: Unknown
Symptoms: Injection site reaction, Pyrexia

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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: fever, inject site reaction, swelling in right thigh


Changed on 6/14/2018

VAERS ID: 25051 Before After
VAERS Form:1
Age:5.0
Sex:Male
Location:California
Vaccinated:1990-05-04
Onset:1990-05-05
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0B11038 / 5 RL / IM

Administered by: Military      Purchased by: Unknown
Symptoms: Injection site reaction, Pyrexia

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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: fever, inject site reaction, swelling in right thigh


Changed on 8/14/2018

VAERS ID: 25051 Before After
VAERS Form:1
Age:5.0
Sex:Male
Location:California
Vaccinated:1990-05-04
Onset:1990-05-05
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0B11038 / 5 RL / IM

Administered by: Military      Purchased by: Unknown
Symptoms: Injection site reaction, Pyrexia

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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: fever, inject site reaction, swelling in right thigh


Changed on 9/14/2018

VAERS ID: 25051 Before After
VAERS Form:1
Age:5.0
Sex:Male
Location:California
Vaccinated:1990-05-04
Onset:1990-05-05
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0B11038 / 5 RL / IM

Administered by: Military      Purchased by: Unknown
Symptoms: Injection site reaction, Pyrexia

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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: fever, inject site reaction, swelling in right thigh


Changed on 10/14/2018

VAERS ID: 25051 Before After
VAERS Form:1
Age:5.0
Sex:Male
Location:California
Vaccinated:1990-05-04
Onset:1990-05-05
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0B11038 / 5 RL / IM

Administered by: Military      Purchased by: Unknown
Symptoms: Injection site reaction, Pyrexia

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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: fever, inject site reaction, swelling in right thigh


Changed on 12/10/2020

VAERS ID: 25051 Before After
VAERS Form:1
Age:5.0
Sex:Male
Location:California South Dakota
Vaccinated:1990-05-04
Onset:1990-05-05
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0B11038 / 5 RL / IM

Administered by: Military      Purchased by: Unknown
Symptoms: Injection site reaction, Pyrexia

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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: fever, inject site reaction, swelling in right thigh


Changed on 12/24/2020

VAERS ID: 25051 Before After
VAERS Form:1
Age:5.0
Sex:Male
Location:South Dakota
Vaccinated:1990-05-04
Onset:1990-05-05
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0B11038 / 5 RL / IM

Administered by: Military      Purchased by: Unknown
Symptoms: Injection site reaction, Pyrexia

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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: fever, inject site reaction, swelling in right thigh


Changed on 12/30/2020

VAERS ID: 25051 Before After
VAERS Form:1
Age:5.0
Sex:Male
Location:South Dakota
Vaccinated:1990-05-04
Onset:1990-05-05
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0B11038 / 5 RL / IM

Administered by: Military      Purchased by: Unknown
Symptoms: Injection site reaction, Pyrexia

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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: fever, inject site reaction, swelling in right thigh


Changed on 5/7/2021

VAERS ID: 25051 Before After
VAERS Form:1
Age:5.0
Sex:Male
Location:South Dakota
Vaccinated:1990-05-04
Onset:1990-05-05
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0B11038 / 5 RL / IM

Administered by: Military      Purchased by: Unknown
Symptoms: Injection site reaction, Pyrexia

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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: fever, inject site reaction, swelling in right thigh


Changed on 5/21/2021

VAERS ID: 25051 Before After
VAERS Form:1
Age:5.0
Sex:Male
Location:South Dakota
Vaccinated:1990-05-04
Onset:1990-05-05
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0B11038 / 5 RL / IM

Administered by: Military      Purchased by: Unknown
Symptoms: Injection site reaction, Pyrexia

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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: fever, inject site reaction, swelling in right thigh

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