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This is VAERS ID 26339

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 26339
VAERS Form:
Age:0.4
Sex:Male
Location:Virginia
Vaccinated:1990-03-19
Onset:1990-03-20
Submitted:1990-10-22
Entered:1990-10-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP / CONNAUGHT LABS 9B11013 / 0 LL / IM
OPV: ORIMUNE / LEDERLE - / - - / PO

Administered by: Private      Purchased by: Unknown
Symptoms: HYPOTONIA, FEVER

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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: Convulsion in sister with DTP
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Blood Culture - No growth; EEG - Normal; CBC-WBC - 20.7 CSF - no growth; Platelets - 455,000
CDC 'Split Type':

Write-up: Pt vacc. /w DTP/OPV began /w fever shortly /p shot treated w/Tylenol q4h. generalized tonic/clonic seizure last about l hr child taken to hosp & admitted temp of 102.6 discharges after 2 days.


Changed on 12/8/2009

VAERS ID: 26339 Before After
VAERS Form:
Age:0.4
Sex:Male
Location:Virginia
Vaccinated:1990-03-19
Onset:1990-03-20
Submitted:1990-10-22
Entered:1990-10-31 1990-10-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP DTP (NO BRAND NAME) / CONNAUGHT LABS CONNAUGHT LABORATORIES 9B11013 / 0 LL / IM
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES - / - - / PO

Administered by: Private      Purchased by: Unknown Private
Symptoms: Hypotonia, Pyrexia, HYPOTONIA, FEVER

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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: Convulsion in sister with DTP
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Blood Culture - No growth; EEG - Normal; CBC-WBC - 20.7 CSF - no growth; Platelets - 455,000
CDC 'Split Type':

Write-up: Pt vacc. /w DTP/OPV began /w fever shortly /p shot treated w/Tylenol q4h. generalized tonic/clonic seizure last about l hr child taken to hosp & admitted temp of 102.6 discharges after 2 days.


Changed on 5/14/2017

VAERS ID: 26339 Before After
VAERS Form:
Age:0.4
Sex:Male
Location:Virginia
Vaccinated:1990-03-19
Onset:1990-03-20
Submitted:1990-10-22
Entered:1990-10-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 9B11013 / 0 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH - / - - / PO

Administered by: Private      Purchased by: Private
Symptoms: Hypotonia, Pyrexia

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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: Convulsion in sister with DTP DTP~ ()~~~In Sibling
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Blood Culture - No growth; EEG - Normal; CBC-WBC - 20.7 CSF - no growth; Platelets - 455,000
CDC 'Split Type':

Write-up: Pt vacc. /w DTP/OPV began /w fever shortly /p shot treated w/Tylenol q4h. generalized tonic/clonic seizure last about l hr child taken to hosp & admitted temp of 102.6 discharges after 2 days.


Changed on 9/14/2017

VAERS ID: 26339 Before After
VAERS Form:(blank) 1
Age:0.4
Sex:Male
Location:Virginia
Vaccinated:1990-03-19
Onset:1990-03-20
Submitted:1990-10-22
Entered:1990-10-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 9B11013 / 0 1 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH - / - UNK - MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Hypotonia, Pyrexia

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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: Convulsion in sister with DTP~ ()~~~In Sibling
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Blood Culture - No growth; EEG - Normal; CBC-WBC - 20.7 CSF - no growth; Platelets - 455,000
CDC 'Split Type':

Write-up: Pt vacc. /w DTP/OPV began /w fever shortly /p shot treated w/Tylenol q4h. generalized tonic/clonic seizure last about l hr child taken to hosp & admitted temp of 102.6 discharges after 2 days.


Changed on 2/14/2018

VAERS ID: 26339 Before After
VAERS Form:1
Age:0.4
Sex:Male
Location:Virginia
Vaccinated:1990-03-19
Onset:1990-03-20
Submitted:1990-10-22
Entered:1990-10-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 9B11013 / 1 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH - / UNK MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Hypotonia, Pyrexia

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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: Convulsion in sister with DTP~ ()~~~In Sibling
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Blood Culture - No growth; EEG - Normal; CBC-WBC - 20.7 CSF - no growth; Platelets - 455,000
CDC 'Split Type':

Write-up: Pt vacc. /w DTP/OPV began /w fever shortly /p shot treated w/Tylenol q4h. generalized tonic/clonic seizure last about l hr child taken to hosp & admitted temp of 102.6 discharges after 2 days.


Changed on 6/14/2018

VAERS ID: 26339 Before After
VAERS Form:1
Age:0.4
Sex:Male
Location:Virginia
Vaccinated:1990-03-19
Onset:1990-03-20
Submitted:1990-10-22
Entered:1990-10-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 9B11013 / 1 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH - / UNK MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Hypotonia, Pyrexia

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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: Convulsion in sister with DTP~ ()~~~In Sibling
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Blood Culture - No growth; EEG - Normal; CBC-WBC - 20.7 CSF - no growth; Platelets - 455,000
CDC 'Split Type':

Write-up: Pt vacc. /w DTP/OPV began /w fever shortly /p shot treated w/Tylenol q4h. generalized tonic/clonic seizure last about l hr child taken to hosp & admitted temp of 102.6 discharges after 2 days.


Changed on 8/14/2018

VAERS ID: 26339 Before After
VAERS Form:1
Age:0.4
Sex:Male
Location:Virginia
Vaccinated:1990-03-19
Onset:1990-03-20
Submitted:1990-10-22
Entered:1990-10-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 9B11013 / 1 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH - / UNK MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Hypotonia, Pyrexia

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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: Convulsion in sister with DTP~ ()~~~In Sibling
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Blood Culture - No growth; EEG - Normal; CBC-WBC - 20.7 CSF - no growth; Platelets - 455,000
CDC 'Split Type':

Write-up: Pt vacc. /w DTP/OPV began /w fever shortly /p shot treated w/Tylenol q4h. generalized tonic/clonic seizure last about l hr child taken to hosp & admitted temp of 102.6 discharges after 2 days.


Changed on 9/14/2018

VAERS ID: 26339 Before After
VAERS Form:1
Age:0.4
Sex:Male
Location:Virginia
Vaccinated:1990-03-19
Onset:1990-03-20
Submitted:1990-10-22
Entered:1990-10-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 9B11013 / 1 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH - / UNK MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Hypotonia, Pyrexia

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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: Convulsion in sister with DTP~ ()~~~In Sibling
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Blood Culture - No growth; EEG - Normal; CBC-WBC - 20.7 CSF - no growth; Platelets - 455,000
CDC 'Split Type':

Write-up: Pt vacc. /w DTP/OPV began /w fever shortly /p shot treated w/Tylenol q4h. generalized tonic/clonic seizure last about l hr child taken to hosp & admitted temp of 102.6 discharges after 2 days.


Changed on 10/14/2018

VAERS ID: 26339 Before After
VAERS Form:1
Age:0.4
Sex:Male
Location:Virginia
Vaccinated:1990-03-19
Onset:1990-03-20
Submitted:1990-10-22
Entered:1990-10-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 9B11013 / 1 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH - / UNK MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Hypotonia, Pyrexia

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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: Convulsion in sister with DTP~ ()~~~In Sibling
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Blood Culture - No growth; EEG - Normal; CBC-WBC - 20.7 CSF - no growth; Platelets - 455,000
CDC 'Split Type':

Write-up: Pt vacc. /w DTP/OPV began /w fever shortly /p shot treated w/Tylenol q4h. generalized tonic/clonic seizure last about l hr child taken to hosp & admitted temp of 102.6 discharges after 2 days.


Changed on 12/24/2020

VAERS ID: 26339 Before After
VAERS Form:1
Age:0.4
Sex:Male
Location:Virginia
Vaccinated:1990-03-19
Onset:1990-03-20
Submitted:1990-10-22
Entered:1990-10-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 9B11013 / 1 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH - / UNK MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Hypotonia, Pyrexia

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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: Convulsion in sister with DTP~ ()~~~In Sibling
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Blood Culture - No growth; EEG - Normal; CBC-WBC - 20.7 CSF - no growth; Platelets - 455,000
CDC 'Split Type':

Write-up: Pt vacc. /w DTP/OPV began /w fever shortly /p shot treated w/Tylenol q4h. generalized tonic/clonic seizure last about l hr child taken to hosp & admitted temp of 102.6 discharges after 2 days.


Changed on 12/30/2020

VAERS ID: 26339 Before After
VAERS Form:1
Age:0.4
Sex:Male
Location:Virginia
Vaccinated:1990-03-19
Onset:1990-03-20
Submitted:1990-10-22
Entered:1990-10-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 9B11013 / 1 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH - / UNK MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Hypotonia, Pyrexia

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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: Convulsion in sister with DTP~ ()~~~In Sibling
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Blood Culture - No growth; EEG - Normal; CBC-WBC - 20.7 CSF - no growth; Platelets - 455,000
CDC 'Split Type':

Write-up: Pt vacc. /w DTP/OPV began /w fever shortly /p shot treated w/Tylenol q4h. generalized tonic/clonic seizure last about l hr child taken to hosp & admitted temp of 102.6 discharges after 2 days.

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