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This is VAERS ID 26401

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 26401
VAERS Form:
Age:0.5
Sex:Male
Location:Indiana
Vaccinated:1990-10-11
Onset:1990-10-11
Submitted:1990-10-24
Entered:1990-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP / CONNAUGHT LABS 0M11148 / 2 LL / -

Administered by: Private      Purchased by: Unknown
Symptoms: FEVER, VOMIT, SOMNOLENCE, ANOREXIA, INTRACRAN HYPERTENS

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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Prematurity 35-36 wks, transient RDs, jaundice, asthma, otitis media.
Allergies:
Diagnostic Lab Data: CBD - WBc 10,400; HGB 9.7, HCt 33.5%; LP -clera CSF, CSF culture neg, glucose 74 MG%, 4 WBC, 22 RBC, Protein 22 Gram Stain neg
CDC 'Split Type':

Write-up: Pt vaccinated with DTP developed fever, vomiting, lethargy, and bulging fontanelle. Observed closely. No antibiotics given. Bulging fontanelle subsided within hrs after LP. Fever persisted 5 days. Poor appetite for 5-6 days. Full recovery.


Changed on 12/8/2009

VAERS ID: 26401 Before After
VAERS Form:
Age:0.5
Sex:Male
Location:Indiana
Vaccinated:1990-10-11
Onset:1990-10-11
Submitted:1990-10-24
Entered:1990-11-05 1990-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP DTP (NO BRAND NAME) / CONNAUGHT LABS CONNAUGHT LABORATORIES 0M11148 / 2 LL / -

Administered by: Private      Purchased by: Unknown Private
Symptoms: Anorexia, Intracranial pressure increased, Pyrexia, Somnolence, Vomiting, FEVER, VOMIT, SOMNOLENCE, ANOREXIA, INTRACRAN HYPERTENS

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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Prematurity 35-36 wks, transient RDs, jaundice, asthma, otitis media.
Allergies:
Diagnostic Lab Data: CBD - WBc 10,400; HGB 9.7, HCt 33.5%; LP -clera CSF, CSF culture neg, glucose 74 MG%, 4 WBC, 22 RBC, Protein 22 Gram Stain neg
CDC 'Split Type':

Write-up: Pt vaccinated with DTP developed fever, vomiting, lethargy, and bulging fontanelle. Observed closely. No antibiotics given. Bulging fontanelle subsided within hrs after LP. Fever persisted 5 days. Poor appetite for 5-6 days. Full recovery.


Changed on 5/14/2017

VAERS ID: 26401 Before After
VAERS Form:
Age:0.5
Sex:Male
Location:Indiana
Vaccinated:1990-10-11
Onset:1990-10-11
Submitted:1990-10-24
Entered:1990-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0M11148 / 2 LL / -

Administered by: Private      Purchased by: Private
Symptoms: Anorexia, Intracranial pressure increased, Pyrexia, Somnolence, Vomiting

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: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: Prematurity 35-36 wks, transient RDs, jaundice, asthma, otitis media.
Allergies:
Diagnostic Lab Data: CBD - WBc 10,400; HGB 9.7, HCt 33.5%; LP -clera CSF, CSF culture neg, glucose 74 MG%, 4 WBC, 22 RBC, Protein 22 Gram Stain neg
CDC 'Split Type':

Write-up: Pt vaccinated with DTP developed fever, vomiting, lethargy, and bulging fontanelle. Observed closely. No antibiotics given. Bulging fontanelle subsided within hrs after LP. Fever persisted 5 days. Poor appetite for 5-6 days. Full recovery.


Changed on 9/14/2017

VAERS ID: 26401 Before After
VAERS Form:(blank) 1
Age:0.5
Sex:Male
Location:Indiana
Vaccinated:1990-10-11
Onset:1990-10-11
Submitted:1990-10-24
Entered:1990-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0M11148 / 2 3 LL / -

Administered by: Private      Purchased by: Private
Symptoms: Anorexia, Intracranial pressure increased, Pyrexia, Somnolence, Vomiting

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: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: Prematurity 35-36 wks, transient RDs, jaundice, asthma, otitis media.
Allergies:
Diagnostic Lab Data: CBD - WBc 10,400; HGB 9.7, HCt 33.5%; LP -clera CSF, CSF culture neg, glucose 74 MG%, 4 WBC, 22 RBC, Protein 22 Gram Stain neg
CDC 'Split Type':

Write-up: Pt vaccinated with DTP developed fever, vomiting, lethargy, and bulging fontanelle. Observed closely. No antibiotics given. Bulging fontanelle subsided within hrs after LP. Fever persisted 5 days. Poor appetite for 5-6 days. Full recovery.


Changed on 2/14/2018

VAERS ID: 26401 Before After
VAERS Form:1
Age:0.5
Sex:Male
Location:Indiana
Vaccinated:1990-10-11
Onset:1990-10-11
Submitted:1990-10-24
Entered:1990-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0M11148 / 3 LL / -

Administered by: Private      Purchased by: Private
Symptoms: Anorexia, Intracranial pressure increased, Pyrexia, Somnolence, Vomiting

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: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: Prematurity 35-36 wks, transient RDs, jaundice, asthma, otitis media.
Allergies:
Diagnostic Lab Data: CBD - WBc 10,400; HGB 9.7, HCt 33.5%; LP -clera CSF, CSF culture neg, glucose 74 MG%, 4 WBC, 22 RBC, Protein 22 Gram Stain neg
CDC 'Split Type':

Write-up: Pt vaccinated with DTP developed fever, vomiting, lethargy, and bulging fontanelle. Observed closely. No antibiotics given. Bulging fontanelle subsided within hrs after LP. Fever persisted 5 days. Poor appetite for 5-6 days. Full recovery.


Changed on 6/14/2018

VAERS ID: 26401 Before After
VAERS Form:1
Age:0.5
Sex:Male
Location:Indiana
Vaccinated:1990-10-11
Onset:1990-10-11
Submitted:1990-10-24
Entered:1990-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0M11148 / 3 LL / -

Administered by: Private      Purchased by: Private
Symptoms: Anorexia, Intracranial pressure increased, Pyrexia, Somnolence, Vomiting

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: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: Prematurity 35-36 wks, transient RDs, jaundice, asthma, otitis media.
Allergies:
Diagnostic Lab Data: CBD - WBc 10,400; HGB 9.7, HCt 33.5%; LP -clera CSF, CSF culture neg, glucose 74 MG%, 4 WBC, 22 RBC, Protein 22 Gram Stain neg
CDC 'Split Type':

Write-up: Pt vaccinated with DTP developed fever, vomiting, lethargy, and bulging fontanelle. Observed closely. No antibiotics given. Bulging fontanelle subsided within hrs after LP. Fever persisted 5 days. Poor appetite for 5-6 days. Full recovery.


Changed on 8/14/2018

VAERS ID: 26401 Before After
VAERS Form:1
Age:0.5
Sex:Male
Location:Indiana
Vaccinated:1990-10-11
Onset:1990-10-11
Submitted:1990-10-24
Entered:1990-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0M11148 / 3 LL / -

Administered by: Private      Purchased by: Private
Symptoms: Anorexia, Intracranial pressure increased, Pyrexia, Somnolence, Vomiting

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: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: Prematurity 35-36 wks, transient RDs, jaundice, asthma, otitis media.
Allergies:
Diagnostic Lab Data: CBD - WBc 10,400; HGB 9.7, HCt 33.5%; LP -clera CSF, CSF culture neg, glucose 74 MG%, 4 WBC, 22 RBC, Protein 22 Gram Stain neg
CDC 'Split Type':

Write-up: Pt vaccinated with DTP developed fever, vomiting, lethargy, and bulging fontanelle. Observed closely. No antibiotics given. Bulging fontanelle subsided within hrs after LP. Fever persisted 5 days. Poor appetite for 5-6 days. Full recovery.


Changed on 9/14/2018

VAERS ID: 26401 Before After
VAERS Form:1
Age:0.5
Sex:Male
Location:Indiana
Vaccinated:1990-10-11
Onset:1990-10-11
Submitted:1990-10-24
Entered:1990-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0M11148 / 3 LL / -

Administered by: Private      Purchased by: Private
Symptoms: Anorexia, Intracranial pressure increased, Pyrexia, Somnolence, Vomiting

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: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: Prematurity 35-36 wks, transient RDs, jaundice, asthma, otitis media.
Allergies:
Diagnostic Lab Data: CBD - WBc 10,400; HGB 9.7, HCt 33.5%; LP -clera CSF, CSF culture neg, glucose 74 MG%, 4 WBC, 22 RBC, Protein 22 Gram Stain neg
CDC 'Split Type':

Write-up: Pt vaccinated with DTP developed fever, vomiting, lethargy, and bulging fontanelle. Observed closely. No antibiotics given. Bulging fontanelle subsided within hrs after LP. Fever persisted 5 days. Poor appetite for 5-6 days. Full recovery.


Changed on 10/14/2018

VAERS ID: 26401 Before After
VAERS Form:1
Age:0.5
Sex:Male
Location:Indiana
Vaccinated:1990-10-11
Onset:1990-10-11
Submitted:1990-10-24
Entered:1990-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0M11148 / 3 LL / -

Administered by: Private      Purchased by: Private
Symptoms: Anorexia, Intracranial pressure increased, Pyrexia, Somnolence, Vomiting

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: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: Prematurity 35-36 wks, transient RDs, jaundice, asthma, otitis media.
Allergies:
Diagnostic Lab Data: CBD - WBc 10,400; HGB 9.7, HCt 33.5%; LP -clera CSF, CSF culture neg, glucose 74 MG%, 4 WBC, 22 RBC, Protein 22 Gram Stain neg
CDC 'Split Type':

Write-up: Pt vaccinated with DTP developed fever, vomiting, lethargy, and bulging fontanelle. Observed closely. No antibiotics given. Bulging fontanelle subsided within hrs after LP. Fever persisted 5 days. Poor appetite for 5-6 days. Full recovery.


Changed on 12/24/2020

VAERS ID: 26401 Before After
VAERS Form:1
Age:0.5
Sex:Male
Location:Indiana
Vaccinated:1990-10-11
Onset:1990-10-11
Submitted:1990-10-24
Entered:1990-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0M11148 / 3 LL / -

Administered by: Private      Purchased by: Private
Symptoms: Anorexia, Intracranial pressure increased, Pyrexia, Somnolence, Vomiting

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: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: Prematurity 35-36 wks, transient RDs, jaundice, asthma, otitis media.
Allergies:
Diagnostic Lab Data: CBD - WBc 10,400; HGB 9.7, HCt 33.5%; LP -clera CSF, CSF culture neg, glucose 74 MG%, 4 WBC, 22 RBC, Protein 22 Gram Stain neg
CDC 'Split Type':

Write-up: Pt vaccinated with DTP developed fever, vomiting, lethargy, and bulging fontanelle. Observed closely. No antibiotics given. Bulging fontanelle subsided within hrs after LP. Fever persisted 5 days. Poor appetite for 5-6 days. Full recovery.


Changed on 12/30/2020

VAERS ID: 26401 Before After
VAERS Form:1
Age:0.5
Sex:Male
Location:Indiana
Vaccinated:1990-10-11
Onset:1990-10-11
Submitted:1990-10-24
Entered:1990-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0M11148 / 3 LL / -

Administered by: Private      Purchased by: Private
Symptoms: Anorexia, Intracranial pressure increased, Pyrexia, Somnolence, Vomiting

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: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: Prematurity 35-36 wks, transient RDs, jaundice, asthma, otitis media.
Allergies:
Diagnostic Lab Data: CBD - WBc 10,400; HGB 9.7, HCt 33.5%; LP -clera CSF, CSF culture neg, glucose 74 MG%, 4 WBC, 22 RBC, Protein 22 Gram Stain neg
CDC 'Split Type':

Write-up: Pt vaccinated with DTP developed fever, vomiting, lethargy, and bulging fontanelle. Observed closely. No antibiotics given. Bulging fontanelle subsided within hrs after LP. Fever persisted 5 days. Poor appetite for 5-6 days. Full recovery.

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