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History of Changes from the VAERS Wayback Machine |
VAERS ID: | 25817 |
VAERS Form: | |
Age: | 2.6 |
Sex: | Female |
Location: | Maryland |
Vaccinated: | 1990-06-22 |
Onset: | 1990-06-30 |
Submitted: | 0000-00-00 |
Entered: | 1990-08-30 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTP: TRI-IMMUNOL / LEDERLE | 265938 / 3 | - / - |
M: UNK. MEASLES VIRUS LIVE / UNCLASSIFIED | - / - | - / - |
OPV: ORIMUNE / LEDERLE | - / - | - / PO |
Administered by: Private Purchased by: Unknown
Symptoms: CONVULS, FEVER, RASH, ASTHENIA
Life Threatening? No
Birth Defect? No
Died? No
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:
Preexisting Conditions: No hx of seizures in siblings/parents. 1 cousin had convulsions /w high fever.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':
Write-up: Approx. 8 days /p DTP/OPV/MMR immun., child experienced a fever 101T, rash on face & chest, seizure (1 episode) & fatigue for 24 hrs.
Vaccinated: | 1990-06-22 |
Onset: | 1990-06-30 |
Submitted: | 0000-00-00 |
Entered: | 1990-08-30 1990-08-29 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTP: TRI-IMMUNOL DTP (TRI-IMMUNOL) / LEDERLE LEDERLE LABORATORIES | 265938 / 3 | - / - |
M: UNK. MEASLES VIRUS LIVE / UNCLASSIFIED | - / - | - / - |
MEA: MEASLES (NO BRAND NAME) / UNKNOWN MANUFACTURER | - / - | - / - |
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES | - / - | - / PO |
Administered by: Private Purchased by: Unknown
Symptoms: Asthenia, Convulsion, Pyrexia, Rash, CONVULS, FEVER, RASH, ASTHENIA
Life Threatening? No
Birth Defect? No
Died? No
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:
Preexisting Conditions: No hx of seizures in siblings/parents. 1 cousin had convulsions /w high fever.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) 9001348.01
Write-up: Approx. 8 days /p DTP/OPV/MMR immun., child experienced a fever 101T, rash on face & chest, seizure (1 episode) & fatigue for 24 hrs.
Vaccinated: | 1990-06-22 |
Onset: | 1990-06-30 |
Submitted: | 0000-00-00 |
Entered: | 1990-08-29 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES | 265938 / 3 | - / - |
MEA: MEASLES (NO BRAND NAME) / UNKNOWN MANUFACTURER | - / - | - / - |
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES | - / - | - / PO |
Administered by: Private Purchased by: Unknown
Symptoms: Asthenia, Convulsion, Pyrexia, Rash
Life Threatening? No
Birth Defect? No
Died? No
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:
Preexisting Conditions: No hx of seizures in siblings/parents. 1 cousin had convulsions /w high fever.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 9001348.01
Write-up: Approx. 8 days /p DTP/OPV/MMR immun., child experienced a fever 101T, rash on face & chest, seizure (1 episode) & fatigue for 24 hrs.
Vaccinated: | 1990-06-22 |
Onset: | 1990-06-30 |
Submitted: | 0000-00-00 |
Entered: | 1990-08-29 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES | 265938 / 3 | - / - |
MEA: MEASLES (NO BRAND NAME) / UNKNOWN MANUFACTURER MERCK & CO. INC. | - / - | - / - |
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH | - / - | - / PO |
Administered by: Private Purchased by: Unknown
Symptoms: Asthenia, Convulsion, Pyrexia, Rash
Life Threatening? No
Birth Defect? No
Died? No
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:
Preexisting Conditions: No hx of seizures in siblings/parents. 1 cousin had convulsions /w high fever.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 9001348.01
Write-up: Approx. 8 days /p DTP/OPV/MMR immun., child experienced a fever 101T, rash on face & chest, seizure (1 episode) & fatigue for 24 hrs.
Vaccinated: | 1990-06-22 |
Onset: | 1990-06-30 |
Submitted: | 0000-00-00 |
Entered: | 1990-08-29 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES | 265938 / 3 4 | - / - |
MEA: MEASLES (NO BRAND NAME) / MERCK & CO. INC. | - / - UNK | - / - |
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH | - / - UNK | - MO / PO |
Administered by: Private Purchased by: Unknown
Symptoms: Asthenia, Convulsion, Pyrexia, Rash
Life Threatening? No
Birth Defect? No
Died? No
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:
Preexisting Conditions: No hx of seizures in siblings/parents. 1 cousin had convulsions /w high fever.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 9001348.01
Write-up: Approx. 8 days /p DTP/OPV/MMR immun., child experienced a fever 101T, rash on face & chest, seizure (1 episode) & fatigue for 24 hrs.
Vaccinated: | 1990-06-22 |
Onset: | 1990-06-30 |
Submitted: | 0000-00-00 |
Entered: | 1990-08-29 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES | 265938 / 4 | - / - |
MEA: MEASLES (NO BRAND NAME) / MERCK & CO. INC. | - / UNK | - / - |
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH | - / UNK | MO / PO |
Administered by: Private Purchased by: Unknown
Symptoms: Asthenia, Convulsion, Pyrexia, Rash
Life Threatening? No
Birth Defect? No
Died? No
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:
Preexisting Conditions: No hx of seizures in siblings/parents. 1 cousin had convulsions /w high fever.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 9001348.01
Write-up: Approx. 8 days /p DTP/OPV/MMR immun., child experienced a fever 101T, rash on face & chest, seizure (1 episode) & fatigue for 24 hrs.
Vaccinated: | 1990-06-22 |
Onset: | 1990-06-30 |
Submitted: | 0000-00-00 |
Entered: | 1990-08-29 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES | 265938 / 4 | - / - |
MEA: MEASLES (NO BRAND NAME) / MERCK & CO. INC. | - / UNK | - / - |
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH | - / UNK | MO / PO |
Administered by: Private Purchased by: Unknown
Symptoms: Asthenia, Convulsion, Pyrexia, Rash
Life Threatening? No
Birth Defect? No
Died? No
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:
Preexisting Conditions: No hx of seizures in siblings/parents. 1 cousin had convulsions /w high fever.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 9001348.01
Write-up: Approx. 8 days /p DTP/OPV/MMR immun., child experienced a fever 101T, rash on face & chest, seizure (1 episode) & fatigue for 24 hrs.
Vaccinated: | 1990-06-22 |
Onset: | 1990-06-30 |
Submitted: | 0000-00-00 |
Entered: | 1990-08-29 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES | 265938 / 4 | - / - |
MEA: MEASLES (NO BRAND NAME) / MERCK & CO. INC. | - / UNK | - / - |
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH | - / UNK | MO / PO |
Administered by: Private Purchased by: Unknown
Symptoms: Asthenia, Convulsion, Pyrexia, Rash
Life Threatening? No
Birth Defect? No
Died? No
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:
Preexisting Conditions: No hx of seizures in siblings/parents. 1 cousin had convulsions /w high fever.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 9001348.01
Write-up: Approx. 8 days /p DTP/OPV/MMR immun., child experienced a fever 101T, rash on face & chest, seizure (1 episode) & fatigue for 24 hrs.
Vaccinated: | 1990-06-22 |
Onset: | 1990-06-30 |
Submitted: | 0000-00-00 |
Entered: | 1990-08-29 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES | 265938 / 4 | - / - |
MEA: MEASLES (NO BRAND NAME) / MERCK & CO. INC. | - / UNK | - / - |
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH | - / UNK | MO / PO |
Administered by: Private Purchased by: Unknown
Symptoms: Asthenia, Convulsion, Pyrexia, Rash
Life Threatening? No
Birth Defect? No
Died? No
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:
Preexisting Conditions: No hx of seizures in siblings/parents. 1 cousin had convulsions /w high fever.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 9001348.01
Write-up: Approx. 8 days /p DTP/OPV/MMR immun., child experienced a fever 101T, rash on face & chest, seizure (1 episode) & fatigue for 24 hrs.
Vaccinated: | 1990-06-22 |
Onset: | 1990-06-30 |
Submitted: | 0000-00-00 |
Entered: | 1990-08-29 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES | 265938 / 4 | - / - |
MEA: MEASLES (NO BRAND NAME) / MERCK & CO. INC. | - / UNK | - / - |
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH | - / UNK | MO / PO |
Administered by: Private Purchased by: Unknown
Symptoms: Asthenia, Convulsion, Pyrexia, Rash
Life Threatening? No
Birth Defect? No
Died? No
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:
Preexisting Conditions: No hx of seizures in siblings/parents. 1 cousin had convulsions /w high fever.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 9001348.01
Write-up: Approx. 8 days /p DTP/OPV/MMR immun., child experienced a fever 101T, rash on face & chest, seizure (1 episode) & fatigue for 24 hrs.
Vaccinated: | 1990-06-22 |
Onset: | 1990-06-30 |
Submitted: | 0000-00-00 |
Entered: | 1990-08-29 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES | 265938 / 4 | - / - |
MEA: MEASLES (NO BRAND NAME) / MERCK & CO. INC. | - / UNK | - / - |
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH | - / UNK | MO / PO |
Administered by: Private Purchased by: Unknown
Symptoms: Asthenia, Convulsion, Pyrexia, Rash
Life Threatening? No
Birth Defect? No
Died? No
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:
Preexisting Conditions: No hx of seizures in siblings/parents. 1 cousin had convulsions /w high fever.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 9001348.01
Write-up: Approx. 8 days /p DTP/OPV/MMR immun., child experienced a fever 101T, rash on face & chest, seizure (1 episode) & fatigue for 24 hrs.
Vaccinated: | 1990-06-22 |
Onset: | 1990-06-30 |
Submitted: | 0000-00-00 |
Entered: | 1990-08-29 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES | 265938 / 4 | - / - |
MEA: MEASLES (NO BRAND NAME) / MERCK & CO. INC. | - / UNK | - / - |
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH | - / UNK | MO / PO |
Administered by: Private Purchased by: Unknown
Symptoms: Asthenia, Convulsion, Pyrexia, Rash
Life Threatening? No
Birth Defect? No
Died? No
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:
Preexisting Conditions: No hx of seizures in siblings/parents. 1 cousin had convulsions /w high fever.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 9001348.01
Write-up: Approx. 8 days /p DTP/OPV/MMR immun., child experienced a fever 101T, rash on face & chest, seizure (1 episode) & fatigue for 24 hrs.
Link To This Search Result:
https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=25817&WAYBACKHISTORY=ON
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