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This is VAERS ID 26346

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 26346
VAERS Form:
Age:0.4
Sex:Male
Location:North Carolina
Vaccinated:1990-08-07
Onset:1990-08-23
Submitted:1990-10-21
Entered:1990-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 271911 / 1 RL / IM
OPV: ORIMUNE / LEDERLE 271943 / 1 - / PO

Administered by: Private      Purchased by: Unknown
Symptoms: INJECT SITE REACT, FEVER, PAIN

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: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: WBC 9000, 37Segs 5 bands, 52 lymp 6 mono Sedrate 8mm, Xrays rt leg & pelvis & bone scan normal Blood culture Neg, ultrasound neg,
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/OPV developed fever, rt leg pain 23AUG90; Rt thigh swollen & hot, temp 101.6; IV antibiotics & rechecked Follow-up 4SEP90 showed 3x4 CM cyst mass has resolved-never ""pointed"" or drained.


Changed on 12/30/2006

VAERS ID: 26346 Before After
VAERS Form:
Age:0.4
Sex:Male
Location:North Carolina
Vaccinated:1990-08-07
Onset:1990-08-23
Submitted:1990-10-21
Entered:1990-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 271911 / 1 RL / IM
OPV: ORIMUNE / LEDERLE 271943 / 1 - / PO

Administered by: Private      Purchased by: Unknown
Symptoms: INJECT SITE REACT, FEVER, PAIN

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: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: WBC 9000, 37Segs 5 bands, 52 lymp 6 mono Sedrate 8mm, Xrays rt leg & pelvis & bone scan normal Blood culture Neg, ultrasound neg,
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/OPV developed fever, rt leg pain 23AUG90; Rt thigh swollen & hot, temp 101.6; IV antibiotics & rechecked Follow-up 4SEP90 showed 3x4 CM cyst mass has resolved-never ""pointed"" /"pointed/" or drained.


Changed on 12/8/2009

VAERS ID: 26346 Before After
VAERS Form:
Age:0.4
Sex:Male
Location:North Carolina
Vaccinated:1990-08-07
Onset:1990-08-23
Submitted:1990-10-21
Entered:1990-11-02 1990-10-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL DTP (TRI-IMMUNOL) / LEDERLE LEDERLE LABORATORIES 271911 / 1 RL / IM
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES 271943 / 1 - / PO

Administered by: Private      Purchased by: Unknown Public
Symptoms: Injection site reaction, Pain, Pyrexia, INJECT SITE REACT, FEVER, PAIN

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: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: WBC 9000, 37Segs 5 bands, 52 lymp 6 mono Sedrate 8mm, Xrays rt leg & pelvis & bone scan normal Blood culture Neg, ultrasound neg,
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/OPV developed fever, rt leg pain 23AUG90; Rt thigh swollen & hot, temp 101.6; IV antibiotics & rechecked Follow-up 4SEP90 showed 3x4 CM cyst mass has resolved-never /"pointed/" "pointed" or drained.


Changed on 5/14/2017

VAERS ID: 26346 Before After
VAERS Form:
Age:0.4
Sex:Male
Location:North Carolina
Vaccinated:1990-08-07
Onset:1990-08-23
Submitted:1990-10-21
Entered:1990-10-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 271911 / 1 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 271943 / 1 - / PO

Administered by: Private      Purchased by: Public
Symptoms: Injection site reaction, Pain, 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: 5     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: WBC 9000, 37Segs 5 bands, 52 lymp 6 mono Sedrate 8mm, Xrays rt leg & pelvis & bone scan normal Blood culture Neg, ultrasound neg,
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/OPV developed fever, rt leg pain 23AUG90; Rt thigh swollen & hot, temp 101.6; IV antibiotics & rechecked Follow-up 4SEP90 showed 3x4 CM cyst mass has resolved-never "pointed" or drained.


Changed on 9/14/2017

VAERS ID: 26346 Before After
VAERS Form:(blank) 1
Age:0.4
Sex:Male
Location:North Carolina
Vaccinated:1990-08-07
Onset:1990-08-23
Submitted:1990-10-21
Entered:1990-10-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 271911 / 1 2 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 271943 / 1 2 - MO / PO

Administered by: Private      Purchased by: Public
Symptoms: Injection site reaction, Pain, 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: 5     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: WBC 9000, 37Segs 5 bands, 52 lymp 6 mono Sedrate 8mm, Xrays rt leg & pelvis & bone scan normal Blood culture Neg, ultrasound neg,
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/OPV developed fever, rt leg pain 23AUG90; Rt thigh swollen & hot, temp 101.6; IV antibiotics & rechecked Follow-up 4SEP90 showed 3x4 CM cyst mass has resolved-never "pointed" or drained.


Changed on 2/14/2018

VAERS ID: 26346 Before After
VAERS Form:1
Age:0.4
Sex:Male
Location:North Carolina
Vaccinated:1990-08-07
Onset:1990-08-23
Submitted:1990-10-21
Entered:1990-10-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 271911 / 2 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 271943 / 2 MO / PO

Administered by: Private      Purchased by: Public
Symptoms: Injection site reaction, Pain, 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: 5     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: WBC 9000, 37Segs 5 bands, 52 lymp 6 mono Sedrate 8mm, Xrays rt leg & pelvis & bone scan normal Blood culture Neg, ultrasound neg,
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/OPV developed fever, rt leg pain 23AUG90; Rt thigh swollen & hot, temp 101.6; IV antibiotics & rechecked Follow-up 4SEP90 showed 3x4 CM cyst mass has resolved-never "pointed" or drained.


Changed on 6/14/2018

VAERS ID: 26346 Before After
VAERS Form:1
Age:0.4
Sex:Male
Location:North Carolina
Vaccinated:1990-08-07
Onset:1990-08-23
Submitted:1990-10-21
Entered:1990-10-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 271911 / 2 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 271943 / 2 MO / PO

Administered by: Private      Purchased by: Public
Symptoms: Injection site reaction, Pain, 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: 5     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: WBC 9000, 37Segs 5 bands, 52 lymp 6 mono Sedrate 8mm, Xrays rt leg & pelvis & bone scan normal Blood culture Neg, ultrasound neg,
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/OPV developed fever, rt leg pain 23AUG90; Rt thigh swollen & hot, temp 101.6; IV antibiotics & rechecked Follow-up 4SEP90 showed 3x4 CM cyst mass has resolved-never "pointed" or drained.


Changed on 8/14/2018

VAERS ID: 26346 Before After
VAERS Form:1
Age:0.4
Sex:Male
Location:North Carolina
Vaccinated:1990-08-07
Onset:1990-08-23
Submitted:1990-10-21
Entered:1990-10-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 271911 / 2 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 271943 / 2 MO / PO

Administered by: Private      Purchased by: Public
Symptoms: Injection site reaction, Pain, 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: 5     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: WBC 9000, 37Segs 5 bands, 52 lymp 6 mono Sedrate 8mm, Xrays rt leg & pelvis & bone scan normal Blood culture Neg, ultrasound neg,
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/OPV developed fever, rt leg pain 23AUG90; Rt thigh swollen & hot, temp 101.6; IV antibiotics & rechecked Follow-up 4SEP90 showed 3x4 CM cyst mass has resolved-never "pointed" or drained.


Changed on 9/14/2018

VAERS ID: 26346 Before After
VAERS Form:1
Age:0.4
Sex:Male
Location:North Carolina
Vaccinated:1990-08-07
Onset:1990-08-23
Submitted:1990-10-21
Entered:1990-10-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 271911 / 2 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 271943 / 2 MO / PO

Administered by: Private      Purchased by: Public
Symptoms: Injection site reaction, Pain, 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: 5     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: WBC 9000, 37Segs 5 bands, 52 lymp 6 mono Sedrate 8mm, Xrays rt leg & pelvis & bone scan normal Blood culture Neg, ultrasound neg,
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/OPV developed fever, rt leg pain 23AUG90; Rt thigh swollen & hot, temp 101.6; IV antibiotics & rechecked Follow-up 4SEP90 showed 3x4 CM cyst mass has resolved-never "pointed" or drained.


Changed on 10/14/2018

VAERS ID: 26346 Before After
VAERS Form:1
Age:0.4
Sex:Male
Location:North Carolina
Vaccinated:1990-08-07
Onset:1990-08-23
Submitted:1990-10-21
Entered:1990-10-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 271911 / 2 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 271943 / 2 MO / PO

Administered by: Private      Purchased by: Public
Symptoms: Injection site reaction, Pain, 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: 5     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: WBC 9000, 37Segs 5 bands, 52 lymp 6 mono Sedrate 8mm, Xrays rt leg & pelvis & bone scan normal Blood culture Neg, ultrasound neg,
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/OPV developed fever, rt leg pain 23AUG90; Rt thigh swollen & hot, temp 101.6; IV antibiotics & rechecked Follow-up 4SEP90 showed 3x4 CM cyst mass has resolved-never "pointed" or drained.


Changed on 12/24/2020

VAERS ID: 26346 Before After
VAERS Form:1
Age:0.4
Sex:Male
Location:North Carolina
Vaccinated:1990-08-07
Onset:1990-08-23
Submitted:1990-10-21
Entered:1990-10-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 271911 / 2 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 271943 / 2 MO / PO

Administered by: Private      Purchased by: Public
Symptoms: Injection site reaction, Pain, 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: 5     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: WBC 9000, 37Segs 5 bands, 52 lymp 6 mono Sedrate 8mm, Xrays rt leg & pelvis & bone scan normal Blood culture Neg, ultrasound neg,
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/OPV developed fever, rt leg pain 23AUG90; Rt thigh swollen & hot, temp 101.6; IV antibiotics & rechecked Follow-up 4SEP90 showed 3x4 CM cyst mass has resolved-never "pointed" or drained.


Changed on 12/30/2020

VAERS ID: 26346 Before After
VAERS Form:1
Age:0.4
Sex:Male
Location:North Carolina
Vaccinated:1990-08-07
Onset:1990-08-23
Submitted:1990-10-21
Entered:1990-10-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 271911 / 2 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 271943 / 2 MO / PO

Administered by: Private      Purchased by: Public
Symptoms: Injection site reaction, Pain, 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: 5     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: WBC 9000, 37Segs 5 bands, 52 lymp 6 mono Sedrate 8mm, Xrays rt leg & pelvis & bone scan normal Blood culture Neg, ultrasound neg,
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/OPV developed fever, rt leg pain 23AUG90; Rt thigh swollen & hot, temp 101.6; IV antibiotics & rechecked Follow-up 4SEP90 showed 3x4 CM cyst mass has resolved-never "pointed" or drained.

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