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This is VAERS ID 86243

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 86243
VAERS Form:
Age:1.3
Sex:Male
Location:Minnesota
Vaccinated:1994-01-26
Onset:1994-02-05
Submitted:1996-05-07
Entered:1996-05-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: TRIPEDIA / CONNAUGHT LABS 3H41035 / 3 RL / -
HIBV: HIBTITER / LEDERLE(PRAXIS) M560KF / 3 RL / -
MMR: MMR II / MSD 1391W / 0 LL / -
OPV: ORIMUNE / LEDERLE 697M2 / 2 - / PO

Administered by: Public      Purchased by: Unknown
Symptoms: AGITATION, CONVULS, EYES GAZE UPWARD, AUTISM, APHASIA

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: gantrisin
Current Illness: ear infect
Preexisting Conditions: NONE-had only 3-4 words
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NONE-had only 3-4 words

Write-up: pt was fussy & w/fever noc a/& all day that noc about 10PM;pt became very hot & given APAP 5min later;911 called took pt to hosp dx autism;behavior changed, (sz disorder), loss eye contact


Changed on 12/8/2009

VAERS ID: 86243 Before After
VAERS Form:
Age:1.3
Sex:Male
Location:Minnesota
Vaccinated:1994-01-26
Onset:1994-02-05
Submitted:1996-05-07
Entered:1996-05-23 1996-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: TRIPEDIA DTAP (TRIPEDIA) / CONNAUGHT LABS CONNAUGHT LABORATORIES 3H41035 / 3 RL / -
HIBV: HIBTITER HIB (HIBTITER) / LEDERLE(PRAXIS) LEDERLE PRAXSIS M560KF / 3 RL / -
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 1391W / 0 LL / -
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES 697M2 / 2 - / PO

Administered by: Public      Purchased by: Unknown Other
Symptoms: Agitation, Aphasia, Autism, Convulsion, Personality disorder, Pyrexia, Speech disorder, Gaze palsy, AGITATION, CONVULS, EYES GAZE UPWARD, AUTISM, APHASIA

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: gantrisin
Current Illness: ear infect
Preexisting Conditions: NONE-had only 3-4 words
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NONE-had only 3-4 words (blank)

Write-up: pt was fussy & w/fever noc a/& all day that noc about 10PM;pt became very hot & given APAP 5min later;911 called took pt to hosp dx autism;behavior changed, (sz disorder), loss eye contact


Changed on 5/14/2017

VAERS ID: 86243 Before After
VAERS Form:
Age:1.3
Sex:Male
Location:Minnesota
Vaccinated:1994-01-26
Onset:1994-02-05
Submitted:1996-05-07
Entered:1996-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 3H41035 / 3 RL / -
HIBV: HIB (HIBTITER) / LEDERLE PRAXSIS PFIZER/WYETH M560KF / 3 RL / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1391W / 0 LL / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 697M2 / 2 - / PO

Administered by: Public      Purchased by: Other
Symptoms: Agitation, Aphasia, Autism, Convulsion, Personality disorder, Pyrexia, Speech disorder, Gaze palsy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: gantrisin
Current Illness: ear infect
Preexisting Conditions: NONE-had only 3-4 words
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt was fussy & w/fever noc a/& all day that noc about 10PM;pt became very hot & given APAP 5min later;911 called took pt to hosp dx autism;behavior changed, (sz disorder), loss eye contact


Changed on 9/14/2017

VAERS ID: 86243 Before After
VAERS Form:(blank) 1
Age:1.3
Sex:Male
Location:Minnesota
Vaccinated:1994-01-26
Onset:1994-02-05
Submitted:1996-05-07
Entered:1996-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 3H41035 / 3 4 RL / -
HIBV: HIB (HIBTITER) / PFIZER/WYETH M560KF / 3 4 RL / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1391W / 0 1 LL / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 697M2 / 2 3 - MO / PO

Administered by: Public      Purchased by: Other
Symptoms: Agitation, Aphasia, Autism, Convulsion, Personality disorder, Pyrexia, Speech disorder, Gaze palsy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: gantrisin
Current Illness: ear infect
Preexisting Conditions: NONE-had only 3-4 words
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt was fussy & w/fever noc a/& all day that noc about 10PM;pt became very hot & given APAP 5min later;911 called took pt to hosp dx autism;behavior changed, (sz disorder), loss eye contact


Changed on 2/14/2018

VAERS ID: 86243 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:Minnesota
Vaccinated:1994-01-26
Onset:1994-02-05
Submitted:1996-05-07
Entered:1996-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 3H41035 / 4 RL / -
HIBV: HIB (HIBTITER) / PFIZER/WYETH M560KF / 4 RL / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1391W / 1 LL / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 697M2 / 3 MO / PO

Administered by: Public      Purchased by: Other
Symptoms: Agitation, Aphasia, Autism, Convulsion, Personality disorder, Pyrexia, Speech disorder, Gaze palsy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: gantrisin
Current Illness: ear infect
Preexisting Conditions: NONE-had only 3-4 words
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt was fussy & w/fever noc a/& all day that noc about 10PM;pt became very hot & given APAP 5min later;911 called took pt to hosp dx autism;behavior changed, (sz disorder), loss eye contact


Changed on 6/14/2018

VAERS ID: 86243 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:Minnesota
Vaccinated:1994-01-26
Onset:1994-02-05
Submitted:1996-05-07
Entered:1996-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 3H41035 / 4 RL / -
HIBV: HIB (HIBTITER) / PFIZER/WYETH M560KF / 4 RL / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1391W / 1 LL / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 697M2 / 3 MO / PO

Administered by: Public      Purchased by: Other
Symptoms: Agitation, Aphasia, Autism, Convulsion, Personality disorder, Pyrexia, Speech disorder, Gaze palsy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: gantrisin
Current Illness: ear infect
Preexisting Conditions: NONE-had only 3-4 words
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt was fussy & w/fever noc a/& all day that noc about 10PM;pt became very hot & given APAP 5min later;911 called took pt to hosp dx autism;behavior changed, (sz disorder), loss eye contact


Changed on 8/14/2018

VAERS ID: 86243 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:Minnesota
Vaccinated:1994-01-26
Onset:1994-02-05
Submitted:1996-05-07
Entered:1996-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 3H41035 / 4 RL / -
HIBV: HIB (HIBTITER) / PFIZER/WYETH M560KF / 4 RL / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1391W / 1 LL / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 697M2 / 3 MO / PO

Administered by: Public      Purchased by: Other
Symptoms: Agitation, Aphasia, Autism, Convulsion, Personality disorder, Pyrexia, Speech disorder, Gaze palsy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: gantrisin
Current Illness: ear infect
Preexisting Conditions: NONE-had only 3-4 words
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt was fussy & w/fever noc a/& all day that noc about 10PM;pt became very hot & given APAP 5min later;911 called took pt to hosp dx autism;behavior changed, (sz disorder), loss eye contact


Changed on 9/14/2018

VAERS ID: 86243 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:Minnesota
Vaccinated:1994-01-26
Onset:1994-02-05
Submitted:1996-05-07
Entered:1996-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 3H41035 / 4 RL / -
HIBV: HIB (HIBTITER) / PFIZER/WYETH M560KF / 4 RL / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1391W / 1 LL / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 697M2 / 3 MO / PO

Administered by: Public      Purchased by: Other
Symptoms: Agitation, Aphasia, Autism, Convulsion, Personality disorder, Pyrexia, Speech disorder, Gaze palsy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: gantrisin
Current Illness: ear infect
Preexisting Conditions: NONE-had only 3-4 words
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt was fussy & w/fever noc a/& all day that noc about 10PM;pt became very hot & given APAP 5min later;911 called took pt to hosp dx autism;behavior changed, (sz disorder), loss eye contact


Changed on 10/14/2018

VAERS ID: 86243 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:Minnesota
Vaccinated:1994-01-26
Onset:1994-02-05
Submitted:1996-05-07
Entered:1996-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 3H41035 / 4 RL / -
HIBV: HIB (HIBTITER) / PFIZER/WYETH M560KF / 4 RL / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1391W / 1 LL / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 697M2 / 3 MO / PO

Administered by: Public      Purchased by: Other
Symptoms: Agitation, Aphasia, Autism, Convulsion, Personality disorder, Pyrexia, Speech disorder, Gaze palsy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: gantrisin
Current Illness: ear infect
Preexisting Conditions: NONE-had only 3-4 words
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt was fussy & w/fever noc a/& all day that noc about 10PM;pt became very hot & given APAP 5min later;911 called took pt to hosp dx autism;behavior changed, (sz disorder), loss eye contact

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