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This is VAERS ID 26310

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 26310
VAERS Form:
Age:0.2
Sex:Male
Location:Utah
Vaccinated:1990-07-09
Onset:1990-07-10
Submitted:1990-10-18
Entered:1990-10-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP / CONNAUGHT LABS - / 0 L / IM

Administered by: Private      Purchased by: Unknown
Symptoms: CYANOSIS, BRADYCARDIA, APNEA

Life Threatening? Yes
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: Vitamin Supplement
Current Illness: Prematurity, chronic lung dz
Preexisting Conditions: Hx of mult med problems, all resolved but chronic lung dz
Allergies:
Diagnostic Lab Data: CBG 1 hr /p event on 40% O2, PH 7.33, PO2 44, PCO2 52, Bicarb 26, Base excess 2.2
CDC 'Split Type':

Write-up: Pt vaccinated with DTP experienced Grade 4 apnea/bradycardia spell approx 23 hrs after immunication with significant cyanosis treated w/vigorous stimulation & increase in oxygen.


Changed on 12/8/2009

VAERS ID: 26310 Before After
VAERS Form:
Age:0.2
Sex:Male
Location:Utah
Vaccinated:1990-07-09
Onset:1990-07-10
Submitted:1990-10-18
Entered:1990-10-31 1990-10-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP DTP (NO BRAND NAME) / CONNAUGHT LABS CONNAUGHT LABORATORIES - / 0 L / IM

Administered by: Private      Purchased by: Unknown Other
Symptoms: Apnoea, Bradycardia, Cyanosis, CYANOSIS, BRADYCARDIA, APNEA

Life Threatening? Yes
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: Vitamin Supplement
Current Illness: Prematurity, chronic lung dz
Preexisting Conditions: Hx of mult med problems, all resolved but chronic lung dz
Allergies:
Diagnostic Lab Data: CBG 1 hr /p event on 40% O2, PH 7.33, PO2 44, PCO2 52, Bicarb 26, Base excess 2.2
CDC 'Split Type':

Write-up: Pt vaccinated with DTP experienced Grade 4 apnea/bradycardia spell approx 23 hrs after immunication with significant cyanosis treated w/vigorous stimulation & increase in oxygen.


Changed on 5/14/2017

VAERS ID: 26310 Before After
VAERS Form:
Age:0.2
Sex:Male
Location:Utah
Vaccinated:1990-07-09
Onset:1990-07-10
Submitted:1990-10-18
Entered:1990-10-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES - / 0 L - / IM IM L

Administered by: Private      Purchased by: Other
Symptoms: Apnoea, Bradycardia, Cyanosis

Life Threatening? Yes
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: Vitamin Supplement
Current Illness: Prematurity, chronic lung dz
Preexisting Conditions: Hx of mult med problems, all resolved but chronic lung dz
Allergies:
Diagnostic Lab Data: CBG 1 hr /p event on 40% O2, PH 7.33, PO2 44, PCO2 52, Bicarb 26, Base excess 2.2
CDC 'Split Type':

Write-up: Pt vaccinated with DTP experienced Grade 4 apnea/bradycardia spell approx 23 hrs after immunication with significant cyanosis treated w/vigorous stimulation & increase in oxygen.


Changed on 9/14/2017

VAERS ID: 26310 Before After
VAERS Form:(blank) 1
Age:0.2
Sex:Male
Location:Utah
Vaccinated:1990-07-09
Onset:1990-07-10
Submitted:1990-10-18
Entered:1990-10-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES - / 0 1 - / IM L

Administered by: Private      Purchased by: Other
Symptoms: Apnoea, Bradycardia, Cyanosis

Life Threatening? Yes
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: Vitamin Supplement
Current Illness: Prematurity, chronic lung dz
Preexisting Conditions: Hx of mult med problems, all resolved but chronic lung dz
Allergies:
Diagnostic Lab Data: CBG 1 hr /p event on 40% O2, PH 7.33, PO2 44, PCO2 52, Bicarb 26, Base excess 2.2
CDC 'Split Type':

Write-up: Pt vaccinated with DTP experienced Grade 4 apnea/bradycardia spell approx 23 hrs after immunication with significant cyanosis treated w/vigorous stimulation & increase in oxygen.


Changed on 2/14/2018

VAERS ID: 26310 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Utah
Vaccinated:1990-07-09
Onset:1990-07-10
Submitted:1990-10-18
Entered:1990-10-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES - / 1 - / IM L

Administered by: Private      Purchased by: Other
Symptoms: Apnoea, Bradycardia, Cyanosis

Life Threatening? Yes
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: Vitamin Supplement
Current Illness: Prematurity, chronic lung dz
Preexisting Conditions: Hx of mult med problems, all resolved but chronic lung dz
Allergies:
Diagnostic Lab Data: CBG 1 hr /p event on 40% O2, PH 7.33, PO2 44, PCO2 52, Bicarb 26, Base excess 2.2
CDC 'Split Type':

Write-up: Pt vaccinated with DTP experienced Grade 4 apnea/bradycardia spell approx 23 hrs after immunication with significant cyanosis treated w/vigorous stimulation & increase in oxygen.


Changed on 6/14/2018

VAERS ID: 26310 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Utah
Vaccinated:1990-07-09
Onset:1990-07-10
Submitted:1990-10-18
Entered:1990-10-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES - / 1 - / IM L

Administered by: Private      Purchased by: Other
Symptoms: Apnoea, Bradycardia, Cyanosis

Life Threatening? Yes
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: Vitamin Supplement
Current Illness: Prematurity, chronic lung dz
Preexisting Conditions: Hx of mult med problems, all resolved but chronic lung dz
Allergies:
Diagnostic Lab Data: CBG 1 hr /p event on 40% O2, PH 7.33, PO2 44, PCO2 52, Bicarb 26, Base excess 2.2
CDC 'Split Type':

Write-up: Pt vaccinated with DTP experienced Grade 4 apnea/bradycardia spell approx 23 hrs after immunication with significant cyanosis treated w/vigorous stimulation & increase in oxygen.


Changed on 8/14/2018

VAERS ID: 26310 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Utah
Vaccinated:1990-07-09
Onset:1990-07-10
Submitted:1990-10-18
Entered:1990-10-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES - / 1 - / IM L

Administered by: Private      Purchased by: Other
Symptoms: Apnoea, Bradycardia, Cyanosis

Life Threatening? Yes
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: Vitamin Supplement
Current Illness: Prematurity, chronic lung dz
Preexisting Conditions: Hx of mult med problems, all resolved but chronic lung dz
Allergies:
Diagnostic Lab Data: CBG 1 hr /p event on 40% O2, PH 7.33, PO2 44, PCO2 52, Bicarb 26, Base excess 2.2
CDC 'Split Type':

Write-up: Pt vaccinated with DTP experienced Grade 4 apnea/bradycardia spell approx 23 hrs after immunication with significant cyanosis treated w/vigorous stimulation & increase in oxygen.


Changed on 9/14/2018

VAERS ID: 26310 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Utah
Vaccinated:1990-07-09
Onset:1990-07-10
Submitted:1990-10-18
Entered:1990-10-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES - / 1 - / IM L

Administered by: Private      Purchased by: Other
Symptoms: Apnoea, Bradycardia, Cyanosis

Life Threatening? Yes
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: Vitamin Supplement
Current Illness: Prematurity, chronic lung dz
Preexisting Conditions: Hx of mult med problems, all resolved but chronic lung dz
Allergies:
Diagnostic Lab Data: CBG 1 hr /p event on 40% O2, PH 7.33, PO2 44, PCO2 52, Bicarb 26, Base excess 2.2
CDC 'Split Type':

Write-up: Pt vaccinated with DTP experienced Grade 4 apnea/bradycardia spell approx 23 hrs after immunication with significant cyanosis treated w/vigorous stimulation & increase in oxygen.


Changed on 10/14/2018

VAERS ID: 26310 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Utah
Vaccinated:1990-07-09
Onset:1990-07-10
Submitted:1990-10-18
Entered:1990-10-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES - / 1 - / IM L

Administered by: Private      Purchased by: Other
Symptoms: Apnoea, Bradycardia, Cyanosis

Life Threatening? Yes
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: Vitamin Supplement
Current Illness: Prematurity, chronic lung dz
Preexisting Conditions: Hx of mult med problems, all resolved but chronic lung dz
Allergies:
Diagnostic Lab Data: CBG 1 hr /p event on 40% O2, PH 7.33, PO2 44, PCO2 52, Bicarb 26, Base excess 2.2
CDC 'Split Type':

Write-up: Pt vaccinated with DTP experienced Grade 4 apnea/bradycardia spell approx 23 hrs after immunication with significant cyanosis treated w/vigorous stimulation & increase in oxygen.


Changed on 12/24/2020

VAERS ID: 26310 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Utah
Vaccinated:1990-07-09
Onset:1990-07-10
Submitted:1990-10-18
Entered:1990-10-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES - / 1 - / IM L

Administered by: Private      Purchased by: Other
Symptoms: Apnoea, Bradycardia, Cyanosis

Life Threatening? Yes
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: Vitamin Supplement
Current Illness: Prematurity, chronic lung dz
Preexisting Conditions: Hx of mult med problems, all resolved but chronic lung dz
Allergies:
Diagnostic Lab Data: CBG 1 hr /p event on 40% O2, PH 7.33, PO2 44, PCO2 52, Bicarb 26, Base excess 2.2
CDC 'Split Type':

Write-up: Pt vaccinated with DTP experienced Grade 4 apnea/bradycardia spell approx 23 hrs after immunication with significant cyanosis treated w/vigorous stimulation & increase in oxygen.


Changed on 12/30/2020

VAERS ID: 26310 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Utah
Vaccinated:1990-07-09
Onset:1990-07-10
Submitted:1990-10-18
Entered:1990-10-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES - / 1 - / IM L

Administered by: Private      Purchased by: Other
Symptoms: Apnoea, Bradycardia, Cyanosis

Life Threatening? Yes
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: Vitamin Supplement
Current Illness: Prematurity, chronic lung dz
Preexisting Conditions: Hx of mult med problems, all resolved but chronic lung dz
Allergies:
Diagnostic Lab Data: CBG 1 hr /p event on 40% O2, PH 7.33, PO2 44, PCO2 52, Bicarb 26, Base excess 2.2
CDC 'Split Type':

Write-up: Pt vaccinated with DTP experienced Grade 4 apnea/bradycardia spell approx 23 hrs after immunication with significant cyanosis treated w/vigorous stimulation & increase in oxygen.

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