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This is VAERS ID 26502

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 26502
VAERS Form:
Age:1.5
Sex:Male
Location:Arizona
Vaccinated:1989-06-01
Onset:1990-10-14
Submitted:0000-00-00
Entered:1990-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP / CONNAUGHT LABS 8E01005 / 3 LL / IM
HIBV: PROHIBIT / CONNAUGHT LABS 8E01081 / 0 RL / IM
OPV: ORIMUNE / LEDERLE 241945 / 2 - / PO

Administered by: Private      Purchased by: Unknown
Symptoms: INFECT, PHARYNGITIS

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: none
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: blood culture positive for H inf. b
CDC 'Split Type':

Write-up: Pt vaccinated with PROHIBIT developed infection Epiglottitis, hospitalized.


Changed on 12/8/2009

VAERS ID: 26502 Before After
VAERS Form:
Age:1.5
Sex:Male
Location:Arizona
Vaccinated:1989-06-01
Onset:1990-10-14
Submitted:0000-00-00
Entered:1990-11-12 1990-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP DTP (NO BRAND NAME) / CONNAUGHT LABS CONNAUGHT LABORATORIES 8E01005 / 3 LL / IM
HIBV: PROHIBIT HIB (PROHIBIT) / CONNAUGHT LABS CONNAUGHT LABORATORIES 8E01081 / 0 RL / IM
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES 241945 / 2 - / PO

Administered by: Private      Purchased by: Unknown Private
Symptoms: Infection, Pharyngitis, INFECT, PHARYNGITIS

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: none
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: blood culture positive for H inf. b
CDC 'Split Type': (blank) CO3674

Write-up: Pt vaccinated with PROHIBIT developed infection Epiglottitis, hospitalized.


Changed on 5/14/2017

VAERS ID: 26502 Before After
VAERS Form:
Age:1.5
Sex:Male
Location:Arizona
Vaccinated:1989-06-01
Onset:1990-10-14
Submitted:0000-00-00
Entered:1990-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 8E01005 / 3 LL / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 8E01081 / 0 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 241945 / 2 - / PO

Administered by: Private      Purchased by: Private
Symptoms: Infection, Pharyngitis

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: none
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: blood culture positive for H inf. b
CDC 'Split Type': CO3674

Write-up: Pt vaccinated with PROHIBIT developed infection Epiglottitis, hospitalized.


Changed on 9/14/2017

VAERS ID: 26502 Before After
VAERS Form:(blank) 1
Age:1.5
Sex:Male
Location:Arizona
Vaccinated:1989-06-01
Onset:1990-10-14
Submitted:0000-00-00
Entered:1990-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 8E01005 / 3 4 LL / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 8E01081 / 0 1 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 241945 / 2 3 - MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Infection, Pharyngitis

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: none
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: blood culture positive for H inf. b
CDC 'Split Type': CO3674

Write-up: Pt vaccinated with PROHIBIT developed infection Epiglottitis, hospitalized.


Changed on 2/14/2018

VAERS ID: 26502 Before After
VAERS Form:1
Age:1.5
Sex:Male
Location:Arizona
Vaccinated:1989-06-01
Onset:1990-10-14
Submitted:0000-00-00
Entered:1990-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 8E01005 / 4 LL / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 8E01081 / 1 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 241945 / 3 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Infection, Pharyngitis

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: none
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: blood culture positive for H inf. b
CDC 'Split Type': CO3674

Write-up: Pt vaccinated with PROHIBIT developed infection Epiglottitis, hospitalized.


Changed on 6/14/2018

VAERS ID: 26502 Before After
VAERS Form:1
Age:1.5
Sex:Male
Location:Arizona
Vaccinated:1989-06-01
Onset:1990-10-14
Submitted:0000-00-00
Entered:1990-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 8E01005 / 4 LL / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 8E01081 / 1 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 241945 / 3 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Infection, Pharyngitis

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: none
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: blood culture positive for H inf. b
CDC 'Split Type': CO3674

Write-up: Pt vaccinated with PROHIBIT developed infection Epiglottitis, hospitalized.


Changed on 8/14/2018

VAERS ID: 26502 Before After
VAERS Form:1
Age:1.5
Sex:Male
Location:Arizona
Vaccinated:1989-06-01
Onset:1990-10-14
Submitted:0000-00-00
Entered:1990-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 8E01005 / 4 LL / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 8E01081 / 1 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 241945 / 3 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Infection, Pharyngitis

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: none
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: blood culture positive for H inf. b
CDC 'Split Type': CO3674

Write-up: Pt vaccinated with PROHIBIT developed infection Epiglottitis, hospitalized.


Changed on 9/14/2018

VAERS ID: 26502 Before After
VAERS Form:1
Age:1.5
Sex:Male
Location:Arizona
Vaccinated:1989-06-01
Onset:1990-10-14
Submitted:0000-00-00
Entered:1990-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 8E01005 / 4 LL / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 8E01081 / 1 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 241945 / 3 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Infection, Pharyngitis

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: none
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: blood culture positive for H inf. b
CDC 'Split Type': CO3674

Write-up: Pt vaccinated with PROHIBIT developed infection Epiglottitis, hospitalized.


Changed on 10/14/2018

VAERS ID: 26502 Before After
VAERS Form:1
Age:1.5
Sex:Male
Location:Arizona
Vaccinated:1989-06-01
Onset:1990-10-14
Submitted:0000-00-00
Entered:1990-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 8E01005 / 4 LL / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 8E01081 / 1 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 241945 / 3 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Infection, Pharyngitis

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: none
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: blood culture positive for H inf. b
CDC 'Split Type': CO3674

Write-up: Pt vaccinated with PROHIBIT developed infection Epiglottitis, hospitalized.


Changed on 12/24/2020

VAERS ID: 26502 Before After
VAERS Form:1
Age:1.5
Sex:Male
Location:Arizona
Vaccinated:1989-06-01
Onset:1990-10-14
Submitted:0000-00-00
Entered:1990-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 8E01005 / 4 LL / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 8E01081 / 1 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 241945 / 3 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Infection, Pharyngitis

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: none
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: blood culture positive for H inf. b
CDC 'Split Type': CO3674

Write-up: Pt vaccinated with PROHIBIT developed infection Epiglottitis, hospitalized.


Changed on 12/30/2020

VAERS ID: 26502 Before After
VAERS Form:1
Age:1.5
Sex:Male
Location:Arizona
Vaccinated:1989-06-01
Onset:1990-10-14
Submitted:0000-00-00
Entered:1990-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 8E01005 / 4 LL / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 8E01081 / 1 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 241945 / 3 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Infection, Pharyngitis

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: none
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: blood culture positive for H inf. b
CDC 'Split Type': CO3674

Write-up: Pt vaccinated with PROHIBIT developed infection Epiglottitis, hospitalized.

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=26502&WAYBACKHISTORY=ON


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