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This is VAERS ID 26492

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 26492
VAERS Form:
Age:0.7
Sex:Male
Location:Pennsylvania
Vaccinated:1990-10-18
Onset:1990-10-18
Submitted:1990-10-30
Entered:1990-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP / CONNAUGHT LABS 0L11101 / 2 LL / -

Administered by: Private      Purchased by: Unknown
Symptoms: AGITATION, FEVER, SCREAMING SYND, FLU SYND, RASH MAC PAP

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Amoxicillin
Current Illness:
Preexisting Conditions: Diarrhea, poss Bronchitis URI
Allergies:
Diagnostic Lab Data: CBC, Blood cultures, Chest x-ray, lumbar puncture & culture spinal fluid.
CDC 'Split Type':

Write-up: Pt vax /w DTP developed T105.6, crying, irritable, less than 24 hrs /p DTP, IV fluids & Rocephin IV & Decadron, cultures all neg; CBC consisant /w viral synd also had maculopapular rash. pt improved & decreased fever, D/C /w no restrctions.


Changed on 12/8/2009

VAERS ID: 26492 Before After
VAERS Form:
Age:0.7
Sex:Male
Location:Pennsylvania
Vaccinated:1990-10-18
Onset:1990-10-18
Submitted:1990-10-30
Entered:1990-11-12 1990-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP DTP (NO BRAND NAME) / CONNAUGHT LABS CONNAUGHT LABORATORIES 0L11101 / 2 LL / -

Administered by: Private      Purchased by: Unknown
Symptoms: Agitation, Influenza, Pyrexia, Rash maculo-papular, Screaming, AGITATION, FEVER, SCREAMING SYND, FLU SYND, RASH MAC PAP

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Amoxicillin
Current Illness:
Preexisting Conditions: Diarrhea, poss Bronchitis URI
Allergies:
Diagnostic Lab Data: CBC, Blood cultures, Chest x-ray, lumbar puncture & culture spinal fluid.
CDC 'Split Type':

Write-up: Pt vax /w DTP developed T105.6, crying, irritable, less than 24 hrs /p DTP, IV fluids & Rocephin IV & Decadron, cultures all neg; CBC consisant /w viral synd also had maculopapular rash. pt improved & decreased fever, D/C /w no restrctions.


Changed on 5/14/2017

VAERS ID: 26492 Before After
VAERS Form:
Age:0.7
Sex:Male
Location:Pennsylvania
Vaccinated:1990-10-18
Onset:1990-10-18
Submitted:1990-10-30
Entered:1990-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0L11101 / 2 LL / -

Administered by: Private      Purchased by: Unknown
Symptoms: Agitation, Influenza, Pyrexia, Rash maculo-papular, Screaming

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Amoxicillin
Current Illness:
Preexisting Conditions: Diarrhea, poss Bronchitis URI
Allergies:
Diagnostic Lab Data: CBC, Blood cultures, Chest x-ray, lumbar puncture & culture spinal fluid.
CDC 'Split Type':

Write-up: Pt vax /w DTP developed T105.6, crying, irritable, less than 24 hrs /p DTP, IV fluids & Rocephin IV & Decadron, cultures all neg; CBC consisant /w viral synd also had maculopapular rash. pt improved & decreased fever, D/C /w no restrctions.


Changed on 9/14/2017

VAERS ID: 26492 Before After
VAERS Form:(blank) 1
Age:0.7
Sex:Male
Location:Pennsylvania
Vaccinated:1990-10-18
Onset:1990-10-18
Submitted:1990-10-30
Entered:1990-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0L11101 / 2 3 LL / -

Administered by: Private      Purchased by: Unknown
Symptoms: Agitation, Influenza, Pyrexia, Rash maculo-papular, Screaming

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Amoxicillin
Current Illness:
Preexisting Conditions: Diarrhea, poss Bronchitis URI
Allergies:
Diagnostic Lab Data: CBC, Blood cultures, Chest x-ray, lumbar puncture & culture spinal fluid.
CDC 'Split Type':

Write-up: Pt vax /w DTP developed T105.6, crying, irritable, less than 24 hrs /p DTP, IV fluids & Rocephin IV & Decadron, cultures all neg; CBC consisant /w viral synd also had maculopapular rash. pt improved & decreased fever, D/C /w no restrctions.


Changed on 2/14/2018

VAERS ID: 26492 Before After
VAERS Form:1
Age:0.7
Sex:Male
Location:Pennsylvania
Vaccinated:1990-10-18
Onset:1990-10-18
Submitted:1990-10-30
Entered:1990-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0L11101 / 3 LL / -

Administered by: Private      Purchased by: Unknown
Symptoms: Agitation, Influenza, Pyrexia, Rash maculo-papular, Screaming

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Amoxicillin
Current Illness:
Preexisting Conditions: Diarrhea, poss Bronchitis URI
Allergies:
Diagnostic Lab Data: CBC, Blood cultures, Chest x-ray, lumbar puncture & culture spinal fluid.
CDC 'Split Type':

Write-up: Pt vax /w DTP developed T105.6, crying, irritable, less than 24 hrs /p DTP, IV fluids & Rocephin IV & Decadron, cultures all neg; CBC consisant /w viral synd also had maculopapular rash. pt improved & decreased fever, D/C /w no restrctions.


Changed on 6/14/2018

VAERS ID: 26492 Before After
VAERS Form:1
Age:0.7
Sex:Male
Location:Pennsylvania
Vaccinated:1990-10-18
Onset:1990-10-18
Submitted:1990-10-30
Entered:1990-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0L11101 / 3 LL / -

Administered by: Private      Purchased by: Unknown
Symptoms: Agitation, Influenza, Pyrexia, Rash maculo-papular, Screaming

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Amoxicillin
Current Illness:
Preexisting Conditions: Diarrhea, poss Bronchitis URI
Allergies:
Diagnostic Lab Data: CBC, Blood cultures, Chest x-ray, lumbar puncture & culture spinal fluid.
CDC 'Split Type':

Write-up: Pt vax /w DTP developed T105.6, crying, irritable, less than 24 hrs /p DTP, IV fluids & Rocephin IV & Decadron, cultures all neg; CBC consisant /w viral synd also had maculopapular rash. pt improved & decreased fever, D/C /w no restrctions.


Changed on 8/14/2018

VAERS ID: 26492 Before After
VAERS Form:1
Age:0.7
Sex:Male
Location:Pennsylvania
Vaccinated:1990-10-18
Onset:1990-10-18
Submitted:1990-10-30
Entered:1990-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0L11101 / 3 LL / -

Administered by: Private      Purchased by: Unknown
Symptoms: Agitation, Influenza, Pyrexia, Rash maculo-papular, Screaming

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Amoxicillin
Current Illness:
Preexisting Conditions: Diarrhea, poss Bronchitis URI
Allergies:
Diagnostic Lab Data: CBC, Blood cultures, Chest x-ray, lumbar puncture & culture spinal fluid.
CDC 'Split Type':

Write-up: Pt vax /w DTP developed T105.6, crying, irritable, less than 24 hrs /p DTP, IV fluids & Rocephin IV & Decadron, cultures all neg; CBC consisant /w viral synd also had maculopapular rash. pt improved & decreased fever, D/C /w no restrctions.


Changed on 9/14/2018

VAERS ID: 26492 Before After
VAERS Form:1
Age:0.7
Sex:Male
Location:Pennsylvania
Vaccinated:1990-10-18
Onset:1990-10-18
Submitted:1990-10-30
Entered:1990-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0L11101 / 3 LL / -

Administered by: Private      Purchased by: Unknown
Symptoms: Agitation, Influenza, Pyrexia, Rash maculo-papular, Screaming

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Amoxicillin
Current Illness:
Preexisting Conditions: Diarrhea, poss Bronchitis URI
Allergies:
Diagnostic Lab Data: CBC, Blood cultures, Chest x-ray, lumbar puncture & culture spinal fluid.
CDC 'Split Type':

Write-up: Pt vax /w DTP developed T105.6, crying, irritable, less than 24 hrs /p DTP, IV fluids & Rocephin IV & Decadron, cultures all neg; CBC consisant /w viral synd also had maculopapular rash. pt improved & decreased fever, D/C /w no restrctions.


Changed on 10/14/2018

VAERS ID: 26492 Before After
VAERS Form:1
Age:0.7
Sex:Male
Location:Pennsylvania
Vaccinated:1990-10-18
Onset:1990-10-18
Submitted:1990-10-30
Entered:1990-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0L11101 / 3 LL / -

Administered by: Private      Purchased by: Unknown
Symptoms: Agitation, Influenza, Pyrexia, Rash maculo-papular, Screaming

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Amoxicillin
Current Illness:
Preexisting Conditions: Diarrhea, poss Bronchitis URI
Allergies:
Diagnostic Lab Data: CBC, Blood cultures, Chest x-ray, lumbar puncture & culture spinal fluid.
CDC 'Split Type':

Write-up: Pt vax /w DTP developed T105.6, crying, irritable, less than 24 hrs /p DTP, IV fluids & Rocephin IV & Decadron, cultures all neg; CBC consisant /w viral synd also had maculopapular rash. pt improved & decreased fever, D/C /w no restrctions.


Changed on 12/24/2020

VAERS ID: 26492 Before After
VAERS Form:1
Age:0.7
Sex:Male
Location:Pennsylvania
Vaccinated:1990-10-18
Onset:1990-10-18
Submitted:1990-10-30
Entered:1990-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0L11101 / 3 LL / -

Administered by: Private      Purchased by: Unknown
Symptoms: Agitation, Influenza, Pyrexia, Rash maculo-papular, Screaming

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Amoxicillin
Current Illness:
Preexisting Conditions: Diarrhea, poss Bronchitis URI
Allergies:
Diagnostic Lab Data: CBC, Blood cultures, Chest x-ray, lumbar puncture & culture spinal fluid.
CDC 'Split Type':

Write-up: Pt vax /w DTP developed T105.6, crying, irritable, less than 24 hrs /p DTP, IV fluids & Rocephin IV & Decadron, cultures all neg; CBC consisant /w viral synd also had maculopapular rash. pt improved & decreased fever, D/C /w no restrctions.


Changed on 12/30/2020

VAERS ID: 26492 Before After
VAERS Form:1
Age:0.7
Sex:Male
Location:Pennsylvania
Vaccinated:1990-10-18
Onset:1990-10-18
Submitted:1990-10-30
Entered:1990-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0L11101 / 3 LL / -

Administered by: Private      Purchased by: Unknown
Symptoms: Agitation, Influenza, Pyrexia, Rash maculo-papular, Screaming

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Amoxicillin
Current Illness:
Preexisting Conditions: Diarrhea, poss Bronchitis URI
Allergies:
Diagnostic Lab Data: CBC, Blood cultures, Chest x-ray, lumbar puncture & culture spinal fluid.
CDC 'Split Type':

Write-up: Pt vax /w DTP developed T105.6, crying, irritable, less than 24 hrs /p DTP, IV fluids & Rocephin IV & Decadron, cultures all neg; CBC consisant /w viral synd also had maculopapular rash. pt improved & decreased fever, D/C /w no restrctions.

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