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This is VAERS ID 25063

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History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 25063
VAERS Form:
Age:0.4
Sex:Female
Location:Illinois
Vaccinated:1990-06-27
Onset:1990-06-27
Submitted:0000-00-00
Entered:1990-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 65929 / - - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: FEVER, SCREAMING SYND, RASH

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: acetaminophen
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: fever 105-105.4 for about 16 hrs crying uncontrollably, started about 2 hrs /p receiving DTP. Pt examined 29-jun-90 has rash that looks like enterovirus. Her fever has resolved & she is clinically fine.


Changed on 12/8/2009

VAERS ID: 25063 Before After
VAERS Form:
Age:0.4
Sex:Female
Location:Illinois
Vaccinated:1990-06-27
Onset:1990-06-27
Submitted:0000-00-00
Entered:1990-07-12 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL DTP (TRI-IMMUNOL) / LEDERLE LEDERLE LABORATORIES 65929 / - - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Pyrexia, Rash, Screaming, FEVER, SCREAMING SYND, RASH

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: acetaminophen
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: fever 105-105.4 for about 16 hrs crying uncontrollably, started about 2 hrs /p receiving DTP. Pt examined 29-jun-90 has rash that looks like enterovirus. Her fever has resolved & she is clinically fine.


Changed on 5/14/2017

VAERS ID: 25063 Before After
VAERS Form:
Age:0.4
Sex:Female
Location:Illinois
Vaccinated:1990-06-27
Onset:1990-06-27
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 65929 / - - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Pyrexia, Rash, Screaming

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: acetaminophen
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: fever 105-105.4 for about 16 hrs crying uncontrollably, started about 2 hrs /p receiving DTP. Pt examined 29-jun-90 has rash that looks like enterovirus. Her fever has resolved & she is clinically fine.


Changed on 9/14/2017

VAERS ID: 25063 Before After
VAERS Form:(blank) 1
Age:0.4
Sex:Female
Location:Illinois
Vaccinated:1990-06-27
Onset:1990-06-27
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 65929 / - UNK - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Pyrexia, Rash, Screaming

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: acetaminophen
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: fever 105-105.4 for about 16 hrs crying uncontrollably, started about 2 hrs /p receiving DTP. Pt examined 29-jun-90 has rash that looks like enterovirus. Her fever has resolved & she is clinically fine.


Changed on 2/14/2018

VAERS ID: 25063 Before After
VAERS Form:1
Age:0.4
Sex:Female
Location:Illinois
Vaccinated:1990-06-27
Onset:1990-06-27
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 65929 / UNK - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Pyrexia, Rash, Screaming

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: acetaminophen
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: fever 105-105.4 for about 16 hrs crying uncontrollably, started about 2 hrs /p receiving DTP. Pt examined 29-jun-90 has rash that looks like enterovirus. Her fever has resolved & she is clinically fine.


Changed on 6/14/2018

VAERS ID: 25063 Before After
VAERS Form:1
Age:0.4
Sex:Female
Location:Illinois
Vaccinated:1990-06-27
Onset:1990-06-27
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 65929 / UNK - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Pyrexia, Rash, Screaming

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: acetaminophen
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: fever 105-105.4 for about 16 hrs crying uncontrollably, started about 2 hrs /p receiving DTP. Pt examined 29-jun-90 has rash that looks like enterovirus. Her fever has resolved & she is clinically fine.


Changed on 8/14/2018

VAERS ID: 25063 Before After
VAERS Form:1
Age:0.4
Sex:Female
Location:Illinois
Vaccinated:1990-06-27
Onset:1990-06-27
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 65929 / UNK - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Pyrexia, Rash, Screaming

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: acetaminophen
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: fever 105-105.4 for about 16 hrs crying uncontrollably, started about 2 hrs /p receiving DTP. Pt examined 29-jun-90 has rash that looks like enterovirus. Her fever has resolved & she is clinically fine.


Changed on 9/14/2018

VAERS ID: 25063 Before After
VAERS Form:1
Age:0.4
Sex:Female
Location:Illinois
Vaccinated:1990-06-27
Onset:1990-06-27
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 65929 / UNK - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Pyrexia, Rash, Screaming

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: acetaminophen
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: fever 105-105.4 for about 16 hrs crying uncontrollably, started about 2 hrs /p receiving DTP. Pt examined 29-jun-90 has rash that looks like enterovirus. Her fever has resolved & she is clinically fine.


Changed on 10/14/2018

VAERS ID: 25063 Before After
VAERS Form:1
Age:0.4
Sex:Female
Location:Illinois
Vaccinated:1990-06-27
Onset:1990-06-27
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 65929 / UNK - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Pyrexia, Rash, Screaming

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: acetaminophen
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: fever 105-105.4 for about 16 hrs crying uncontrollably, started about 2 hrs /p receiving DTP. Pt examined 29-jun-90 has rash that looks like enterovirus. Her fever has resolved & she is clinically fine.


Changed on 12/24/2020

VAERS ID: 25063 Before After
VAERS Form:1
Age:0.4
Sex:Female
Location:Illinois
Vaccinated:1990-06-27
Onset:1990-06-27
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 65929 / UNK - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Pyrexia, Rash, Screaming

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: acetaminophen
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: fever 105-105.4 for about 16 hrs crying uncontrollably, started about 2 hrs /p receiving DTP. Pt examined 29-jun-90 has rash that looks like enterovirus. Her fever has resolved & she is clinically fine.


Changed on 12/30/2020

VAERS ID: 25063 Before After
VAERS Form:1
Age:0.4
Sex:Female
Location:Illinois
Vaccinated:1990-06-27
Onset:1990-06-27
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 65929 / UNK - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Pyrexia, Rash, Screaming

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: acetaminophen
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: fever 105-105.4 for about 16 hrs crying uncontrollably, started about 2 hrs /p receiving DTP. Pt examined 29-jun-90 has rash that looks like enterovirus. Her fever has resolved & she is clinically fine.


Changed on 5/7/2021

VAERS ID: 25063 Before After
VAERS Form:1
Age:0.4
Sex:Female
Location:Illinois
Vaccinated:1990-06-27
Onset:1990-06-27
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 65929 / UNK - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Pyrexia, Rash, Screaming

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: acetaminophen
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: fever 105-105.4 for about 16 hrs crying uncontrollably, started about 2 hrs /p receiving DTP. Pt examined 29-jun-90 has rash that looks like enterovirus. Her fever has resolved & she is clinically fine.


Changed on 5/21/2021

VAERS ID: 25063 Before After
VAERS Form:1
Age:0.4
Sex:Female
Location:Illinois
Vaccinated:1990-06-27
Onset:1990-06-27
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 65929 / UNK - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Pyrexia, Rash, Screaming

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: acetaminophen
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: fever 105-105.4 for about 16 hrs crying uncontrollably, started about 2 hrs /p receiving DTP. Pt examined 29-jun-90 has rash that looks like enterovirus. Her fever has resolved & she is clinically fine.

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