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This is VAERS ID 61839

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 61839
VAERS Form:
Age:1.6
Sex:Male
Location:Pennsylvania
Vaccinated:1993-07-28
Onset:1993-08-06
Submitted:1994-01-31
Entered:1994-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP / CONNAUGHT LABS 3H41043 / 2 LL / -
HIBV: HIBTITER / LEDERLE(PRAXIS) M020JE / 2 RL / -
MMR: MMR II / MSD 1052V / 0 RL / SC
OPV: ORIMUNE / LEDERLE 338920 / 2 - / PO

Administered by: Public      Purchased by: Unknown
Symptoms: CONVULS, FEVER, APNEA, RASH MAC PAP

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: NA
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: meconium blackagl at birth
Allergies:
Diagnostic Lab Data: spinal tap & blood-now growth WBc 10.7;
CDC 'Split Type': meconium blackagl at birth

Write-up: 6AUG93 pt stopped breathing mouth to mouth given t104.7, sz; CSF & blood OK; 10AUG94 fine erythematous generalized rash dx rosella;


Changed on 12/8/2009

VAERS ID: 61839 Before After
VAERS Form:
Age:1.6
Sex:Male
Location:Pennsylvania
Vaccinated:1993-07-28
Onset:1993-08-06
Submitted:1994-01-31
Entered:1994-04-22 1994-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP DTP (NO BRAND NAME) / CONNAUGHT LABS CONNAUGHT LABORATORIES 3H41043 / 2 LL / -
HIBV: HIBTITER HIB (HIBTITER) / LEDERLE(PRAXIS) LEDERLE PRAXSIS M020JE / 2 RL / -
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 1052V / 0 RL / SC
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES 338920 / 2 - / PO

Administered by: Public      Purchased by: Unknown Public
Symptoms: Apnoea, Convulsion, Pyrexia, Rash maculo-papular, CONVULS, FEVER, APNEA, RASH MAC PAP

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: NA
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: meconium blackagl at birth
Allergies:
Diagnostic Lab Data: spinal tap & blood-now growth WBc 10.7;
CDC 'Split Type': meconium blackagl at birth PA93188

Write-up: 6AUG93 pt stopped breathing mouth to mouth given t104.7, sz; CSF & blood OK; 10AUG94 fine erythematous generalized rash dx rosella;


Changed on 5/14/2017

VAERS ID: 61839 Before After
VAERS Form:
Age:1.6
Sex:Male
Location:Pennsylvania
Vaccinated:1993-07-28
Onset:1993-08-06
Submitted:1994-01-31
Entered:1994-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 3H41043 / 2 LL / -
HIBV: HIB (HIBTITER) / LEDERLE PRAXSIS PFIZER/WYETH M020JE / 2 RL / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1052V / 0 RL / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 338920 / 2 - / PO

Administered by: Public      Purchased by: Public
Symptoms: Apnoea, Convulsion, Pyrexia, Rash maculo-papular

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: NA NA~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: meconium blackagl at birth
Allergies:
Diagnostic Lab Data: spinal tap & blood-now growth WBc 10.7;
CDC 'Split Type': PA93188

Write-up: 6AUG93 pt stopped breathing mouth to mouth given t104.7, sz; CSF & blood OK; 10AUG94 fine erythematous generalized rash dx rosella;


Changed on 9/14/2017

VAERS ID: 61839 Before After
VAERS Form:(blank) 1
Age:1.6
Sex:Male
Location:Pennsylvania
Vaccinated:1993-07-28
Onset:1993-08-06
Submitted:1994-01-31
Entered:1994-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 3H41043 / 2 3 LL / -
HIBV: HIB (HIBTITER) / PFIZER/WYETH M020JE / 2 3 RL / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1052V / 0 1 RL / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 338920 / 2 3 - MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Apnoea, Convulsion, Pyrexia, Rash maculo-papular

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: NA~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: meconium blackagl at birth
Allergies:
Diagnostic Lab Data: spinal tap & blood-now growth WBc 10.7;
CDC 'Split Type': PA93188

Write-up: 6AUG93 pt stopped breathing mouth to mouth given t104.7, sz; CSF & blood OK; 10AUG94 fine erythematous generalized rash dx rosella;


Changed on 2/14/2018

VAERS ID: 61839 Before After
VAERS Form:1
Age:1.6
Sex:Male
Location:Pennsylvania
Vaccinated:1993-07-28
Onset:1993-08-06
Submitted:1994-01-31
Entered:1994-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 3H41043 / 3 LL / -
HIBV: HIB (HIBTITER) / PFIZER/WYETH M020JE / 3 RL / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1052V / 1 RL / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 338920 / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Apnoea, Convulsion, Pyrexia, Rash maculo-papular

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: NA~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: meconium blackagl at birth
Allergies:
Diagnostic Lab Data: spinal tap & blood-now growth WBc 10.7;
CDC 'Split Type': PA93188

Write-up: 6AUG93 pt stopped breathing mouth to mouth given t104.7, sz; CSF & blood OK; 10AUG94 fine erythematous generalized rash dx rosella;


Changed on 6/14/2018

VAERS ID: 61839 Before After
VAERS Form:1
Age:1.6
Sex:Male
Location:Pennsylvania
Vaccinated:1993-07-28
Onset:1993-08-06
Submitted:1994-01-31
Entered:1994-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 3H41043 / 3 LL / -
HIBV: HIB (HIBTITER) / PFIZER/WYETH M020JE / 3 RL / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1052V / 1 RL / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 338920 / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Apnoea, Convulsion, Pyrexia, Rash maculo-papular

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: NA~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: meconium blackagl at birth
Allergies:
Diagnostic Lab Data: spinal tap & blood-now growth WBc 10.7;
CDC 'Split Type': PA93188

Write-up: 6AUG93 pt stopped breathing mouth to mouth given t104.7, sz; CSF & blood OK; 10AUG94 fine erythematous generalized rash dx rosella;


Changed on 8/14/2018

VAERS ID: 61839 Before After
VAERS Form:1
Age:1.6
Sex:Male
Location:Pennsylvania
Vaccinated:1993-07-28
Onset:1993-08-06
Submitted:1994-01-31
Entered:1994-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 3H41043 / 3 LL / -
HIBV: HIB (HIBTITER) / PFIZER/WYETH M020JE / 3 RL / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1052V / 1 RL / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 338920 / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Apnoea, Convulsion, Pyrexia, Rash maculo-papular

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: NA~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: meconium blackagl at birth
Allergies:
Diagnostic Lab Data: spinal tap & blood-now growth WBc 10.7;
CDC 'Split Type': PA93188

Write-up: 6AUG93 pt stopped breathing mouth to mouth given t104.7, sz; CSF & blood OK; 10AUG94 fine erythematous generalized rash dx rosella;


Changed on 9/14/2018

VAERS ID: 61839 Before After
VAERS Form:1
Age:1.6
Sex:Male
Location:Pennsylvania
Vaccinated:1993-07-28
Onset:1993-08-06
Submitted:1994-01-31
Entered:1994-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 3H41043 / 3 LL / -
HIBV: HIB (HIBTITER) / PFIZER/WYETH M020JE / 3 RL / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1052V / 1 RL / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 338920 / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Apnoea, Convulsion, Pyrexia, Rash maculo-papular

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: NA~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: meconium blackagl at birth
Allergies:
Diagnostic Lab Data: spinal tap & blood-now growth WBc 10.7;
CDC 'Split Type': PA93188

Write-up: 6AUG93 pt stopped breathing mouth to mouth given t104.7, sz; CSF & blood OK; 10AUG94 fine erythematous generalized rash dx rosella;


Changed on 10/14/2018

VAERS ID: 61839 Before After
VAERS Form:1
Age:1.6
Sex:Male
Location:Pennsylvania
Vaccinated:1993-07-28
Onset:1993-08-06
Submitted:1994-01-31
Entered:1994-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 3H41043 / 3 LL / -
HIBV: HIB (HIBTITER) / PFIZER/WYETH M020JE / 3 RL / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1052V / 1 RL / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 338920 / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Apnoea, Convulsion, Pyrexia, Rash maculo-papular

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: NA~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: meconium blackagl at birth
Allergies:
Diagnostic Lab Data: spinal tap & blood-now growth WBc 10.7;
CDC 'Split Type': PA93188

Write-up: 6AUG93 pt stopped breathing mouth to mouth given t104.7, sz; CSF & blood OK; 10AUG94 fine erythematous generalized rash dx rosella;

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