National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 29397

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 29397
VAERS Form:
Age:0.7
Sex:Female
Location:Pennsylvania
Vaccinated:1991-02-27
Onset:1991-02-28
Submitted:1991-03-08
Entered:1991-04-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 293948 / 2 LL / IM
HIBV: HIBTITER / LEDERLE(PRAXIS) M2053P / 0 RL / IM

Administered by: Public      Purchased by: Unknown
Symptoms: FEVER, RASH, RHINITIS

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: None apparent
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Bloodwork & Urinalysis - normal
CDC 'Split Type': NONE

Write-up: Fever to 104 27FEB91 & 105 28FEB91; To ER 28FEB91; No apparent infect; Had red blotching on face 1MAR91 p/taking Augmentin was discontinued due to poss allergy; continues to have low grade fever & has clear nasal discharge.


Changed on 12/8/2009

VAERS ID: 29397 Before After
VAERS Form:
Age:0.7
Sex:Female
Location:Pennsylvania
Vaccinated:1991-02-27
Onset:1991-02-28
Submitted:1991-03-08
Entered:1991-04-02 1991-03-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL DTP (TRI-IMMUNOL) / LEDERLE LEDERLE LABORATORIES 293948 / 2 LL / IM
HIBV: HIBTITER HIB (HIBTITER) / LEDERLE(PRAXIS) LEDERLE PRAXSIS M2053P / 0 RL / IM

Administered by: Public      Purchased by: Unknown Public
Symptoms: Pyrexia, Rash, Rhinitis, FEVER, RASH, RHINITIS

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: None apparent
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Bloodwork & Urinalysis - normal
CDC 'Split Type': NONE PA9186

Write-up: Fever to 104 27FEB91 & 105 28FEB91; To ER 28FEB91; No apparent infect; Had red blotching on face 1MAR91 p/taking Augmentin was discontinued due to poss allergy; continues to have low grade fever & has clear nasal discharge.


Changed on 5/14/2017

VAERS ID: 29397 Before After
VAERS Form:
Age:0.7
Sex:Female
Location:Pennsylvania
Vaccinated:1991-02-27
Onset:1991-02-28
Submitted:1991-03-08
Entered:1991-03-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 293948 / 2 LL / IM
HIBV: HIB (HIBTITER) / LEDERLE PRAXSIS PFIZER/WYETH M2053P / 0 RL / IM

Administered by: Public      Purchased by: Public
Symptoms: Pyrexia, Rash, Rhinitis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: None apparent
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Bloodwork & Urinalysis - normal
CDC 'Split Type': PA9186

Write-up: Fever to 104 27FEB91 & 105 28FEB91; To ER 28FEB91; No apparent infect; Had red blotching on face 1MAR91 p/taking Augmentin was discontinued due to poss allergy; continues to have low grade fever & has clear nasal discharge.


Changed on 9/14/2017

VAERS ID: 29397 Before After
VAERS Form:(blank) 1
Age:0.7
Sex:Female
Location:Pennsylvania
Vaccinated:1991-02-27
Onset:1991-02-28
Submitted:1991-03-08
Entered:1991-03-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 293948 / 2 3 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M2053P / 0 1 RL / IM

Administered by: Public      Purchased by: Public
Symptoms: Pyrexia, Rash, Rhinitis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: None apparent
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Bloodwork & Urinalysis - normal
CDC 'Split Type': PA9186

Write-up: Fever to 104 27FEB91 & 105 28FEB91; To ER 28FEB91; No apparent infect; Had red blotching on face 1MAR91 p/taking Augmentin was discontinued due to poss allergy; continues to have low grade fever & has clear nasal discharge.


Changed on 2/14/2018

VAERS ID: 29397 Before After
VAERS Form:1
Age:0.7
Sex:Female
Location:Pennsylvania
Vaccinated:1991-02-27
Onset:1991-02-28
Submitted:1991-03-08
Entered:1991-03-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 293948 / 3 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M2053P / 1 RL / IM

Administered by: Public      Purchased by: Public
Symptoms: Pyrexia, Rash, Rhinitis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: None apparent
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Bloodwork & Urinalysis - normal
CDC 'Split Type': PA9186

Write-up: Fever to 104 27FEB91 & 105 28FEB91; To ER 28FEB91; No apparent infect; Had red blotching on face 1MAR91 p/taking Augmentin was discontinued due to poss allergy; continues to have low grade fever & has clear nasal discharge.


Changed on 6/14/2018

VAERS ID: 29397 Before After
VAERS Form:1
Age:0.7
Sex:Female
Location:Pennsylvania
Vaccinated:1991-02-27
Onset:1991-02-28
Submitted:1991-03-08
Entered:1991-03-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 293948 / 3 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M2053P / 1 RL / IM

Administered by: Public      Purchased by: Public
Symptoms: Pyrexia, Rash, Rhinitis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: None apparent
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Bloodwork & Urinalysis - normal
CDC 'Split Type': PA9186

Write-up: Fever to 104 27FEB91 & 105 28FEB91; To ER 28FEB91; No apparent infect; Had red blotching on face 1MAR91 p/taking Augmentin was discontinued due to poss allergy; continues to have low grade fever & has clear nasal discharge.


Changed on 8/14/2018

VAERS ID: 29397 Before After
VAERS Form:1
Age:0.7
Sex:Female
Location:Pennsylvania
Vaccinated:1991-02-27
Onset:1991-02-28
Submitted:1991-03-08
Entered:1991-03-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 293948 / 3 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M2053P / 1 RL / IM

Administered by: Public      Purchased by: Public
Symptoms: Pyrexia, Rash, Rhinitis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: None apparent
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Bloodwork & Urinalysis - normal
CDC 'Split Type': PA9186

Write-up: Fever to 104 27FEB91 & 105 28FEB91; To ER 28FEB91; No apparent infect; Had red blotching on face 1MAR91 p/taking Augmentin was discontinued due to poss allergy; continues to have low grade fever & has clear nasal discharge.


Changed on 9/14/2018

VAERS ID: 29397 Before After
VAERS Form:1
Age:0.7
Sex:Female
Location:Pennsylvania
Vaccinated:1991-02-27
Onset:1991-02-28
Submitted:1991-03-08
Entered:1991-03-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 293948 / 3 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M2053P / 1 RL / IM

Administered by: Public      Purchased by: Public
Symptoms: Pyrexia, Rash, Rhinitis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: None apparent
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Bloodwork & Urinalysis - normal
CDC 'Split Type': PA9186

Write-up: Fever to 104 27FEB91 & 105 28FEB91; To ER 28FEB91; No apparent infect; Had red blotching on face 1MAR91 p/taking Augmentin was discontinued due to poss allergy; continues to have low grade fever & has clear nasal discharge.


Changed on 10/14/2018

VAERS ID: 29397 Before After
VAERS Form:1
Age:0.7
Sex:Female
Location:Pennsylvania
Vaccinated:1991-02-27
Onset:1991-02-28
Submitted:1991-03-08
Entered:1991-03-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 293948 / 3 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M2053P / 1 RL / IM

Administered by: Public      Purchased by: Public
Symptoms: Pyrexia, Rash, Rhinitis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: None apparent
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Bloodwork & Urinalysis - normal
CDC 'Split Type': PA9186

Write-up: Fever to 104 27FEB91 & 105 28FEB91; To ER 28FEB91; No apparent infect; Had red blotching on face 1MAR91 p/taking Augmentin was discontinued due to poss allergy; continues to have low grade fever & has clear nasal discharge.

New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=29397&WAYBACKHISTORY=ON


Copyright © 2019 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166