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This is VAERS ID 580878

History of Changes from the VAERS Wayback Machine

First Appeared on 6/13/2015

VAERS ID: 580878
VAERS Form:
Age:0.2
Sex:Female
Location:California
Vaccinated:1990-05-19
Onset:1990-05-19
Submitted:2015-06-08
Entered:2015-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPHEP: DTP + HEP B (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 UN / -
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 UN / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 UN / -
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 UN / -

Administered by: Private      Purchased by: Other
Symptoms: Cold sweat, Crying, Death, Lethargy, Pallor, Laboratory test, Decreased appetite

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-05-21
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? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Patient was on nothing else...
Current Illness: Patient had been mildly ill about a month prior to her vaccinations. She was healthy for several weeks prior to vaccination.
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Too dang many to list you are welcome to get her records
CDC 'Split Type':

Write-up: My daughter got her vaccines and within hours was lethargic, no appetite, clammy to the touch, whimpering and pale.


Changed on 2/14/2017

VAERS ID: 580878 Before After
VAERS Form:
Age:0.2 0.24
Sex:Female
Location:California
Vaccinated:1990-05-19
Onset:1990-05-19
Submitted:2015-06-08
Entered:2015-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPHEP: DTP + HEP B (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 UN / -
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 UN / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 UN / -
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 UN / -

Administered by: Private      Purchased by: Other
Symptoms: Cold sweat, Crying, Death, Lethargy, Pallor, Laboratory test, Decreased appetite

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-05-21
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? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Patient was on nothing else...
Current Illness: Patient had been mildly ill about a month prior to her vaccinations. She was healthy for several weeks prior to vaccination.
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Too dang many to list you are welcome to get her records
CDC 'Split Type':

Write-up: My daughter got her vaccines and within hours was lethargic, no appetite, clammy to the touch, whimpering and pale.


Changed on 9/14/2017

VAERS ID: 580878 Before After
VAERS Form:(blank) 1
Age:0.24
Sex:Female
Location:California
Vaccinated:1990-05-19
Onset:1990-05-19
Submitted:2015-06-08
Entered:2015-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPHEP: DTP + HEP B (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 2 UN / -
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 2 UN / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 2 UN / -
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 2 UN / -

Administered by: Private      Purchased by: Other
Symptoms: Cold sweat, Crying, Death, Lethargy, Pallor, Laboratory test, Decreased appetite

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-05-21
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? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Patient was on nothing else...
Current Illness: Patient had been mildly ill about a month prior to her vaccinations. She was healthy for several weeks prior to vaccination.
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Too dang many to list you are welcome to get her records
CDC 'Split Type':

Write-up: My daughter got her vaccines and within hours was lethargic, no appetite, clammy to the touch, whimpering and pale.


Changed on 2/14/2018

VAERS ID: 580878 Before After
VAERS Form:1
Age:0.24
Sex:Female
Location:California
Vaccinated:1990-05-19
Onset:1990-05-19
Submitted:2015-06-08
Entered:2015-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPHEP: DTP + HEP B (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 UN / -
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 UN / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 UN / -
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 UN / -

Administered by: Private      Purchased by: Other
Symptoms: Cold sweat, Crying, Death, Lethargy, Pallor, Laboratory test, Decreased appetite

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-05-21
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? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Patient was on nothing else...
Current Illness: Patient had been mildly ill about a month prior to her vaccinations. She was healthy for several weeks prior to vaccination.
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Too dang many to list you are welcome to get her records
CDC 'Split Type':

Write-up: My daughter got her vaccines and within hours was lethargic, no appetite, clammy to the touch, whimpering and pale.


Changed on 6/14/2018

VAERS ID: 580878 Before After
VAERS Form:1
Age:0.24
Sex:Female
Location:California
Vaccinated:1990-05-19
Onset:1990-05-19
Submitted:2015-06-08
Entered:2015-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPHEP: DTP + HEP B (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 UN / -
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 UN / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 UN / -
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 UN / -

Administered by: Private      Purchased by: Other
Symptoms: Cold sweat, Crying, Death, Lethargy, Pallor, Laboratory test, Decreased appetite

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-05-21
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? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Patient was on nothing else...
Current Illness: Patient had been mildly ill about a month prior to her vaccinations. She was healthy for several weeks prior to vaccination.
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Too dang many to list you are welcome to get her records
CDC 'Split Type':

Write-up: My daughter got her vaccines and within hours was lethargic, no appetite, clammy to the touch, whimpering and pale.


Changed on 8/14/2018

VAERS ID: 580878 Before After
VAERS Form:1
Age:0.24
Sex:Female
Location:California
Vaccinated:1990-05-19
Onset:1990-05-19
Submitted:2015-06-08
Entered:2015-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPHEP: DTP + HEP B (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 UN / -
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 UN / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 UN / -
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 UN / -

Administered by: Private      Purchased by: Other
Symptoms: Cold sweat, Crying, Death, Lethargy, Pallor, Laboratory test, Decreased appetite

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-05-21
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? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Patient was on nothing else...
Current Illness: Patient had been mildly ill about a month prior to her vaccinations. She was healthy for several weeks prior to vaccination.
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Too dang many to list you are welcome to get her records
CDC 'Split Type':

Write-up: My daughter got her vaccines and within hours was lethargic, no appetite, clammy to the touch, whimpering and pale.


Changed on 9/14/2018

VAERS ID: 580878 Before After
VAERS Form:1
Age:0.24
Sex:Female
Location:California
Vaccinated:1990-05-19
Onset:1990-05-19
Submitted:2015-06-08
Entered:2015-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPHEP: DTP + HEP B (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 UN / -
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 UN / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 UN / -
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 UN / -

Administered by: Private      Purchased by: Other
Symptoms: Cold sweat, Crying, Death, Lethargy, Pallor, Laboratory test, Decreased appetite

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-05-21
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? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Patient was on nothing else...
Current Illness: Patient had been mildly ill about a month prior to her vaccinations. She was healthy for several weeks prior to vaccination.
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Too dang many to list you are welcome to get her records
CDC 'Split Type':

Write-up: My daughter got her vaccines and within hours was lethargic, no appetite, clammy to the touch, whimpering and pale.


Changed on 10/14/2018

VAERS ID: 580878 Before After
VAERS Form:1
Age:0.24
Sex:Female
Location:California
Vaccinated:1990-05-19
Onset:1990-05-19
Submitted:2015-06-08
Entered:2015-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPHEP: DTP + HEP B (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 UN / -
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 UN / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 UN / -
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 UN / -

Administered by: Private      Purchased by: Other
Symptoms: Cold sweat, Crying, Death, Lethargy, Pallor, Laboratory test, Decreased appetite

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-05-21
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? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Patient was on nothing else...
Current Illness: Patient had been mildly ill about a month prior to her vaccinations. She was healthy for several weeks prior to vaccination.
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Too dang many to list you are welcome to get her records
CDC 'Split Type':

Write-up: My daughter got her vaccines and within hours was lethargic, no appetite, clammy to the touch, whimpering and pale.

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=580878&WAYBACKHISTORY=ON


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