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This is VAERS ID 634198

History of Changes from the VAERS Wayback Machine

First Appeared on 6/14/2016

VAERS ID: 634198
VAERS Form:
Age:5.0
Gender:Male
Location:Vermont
Vaccinated:2016-05-02
Onset:2016-05-02
Submitted:2016-05-03
Entered:2016-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPV: DTAP + IPV (KINRIX) / GLAXOSMITHKLINE BIOLOGICALS H53CL / - LA / IM
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD) / MERCK & CO. INC. L031098 / - RA / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Listless, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
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:
Other Medications:
Current Illness: No
Preexisting Conditions: Allergy to Amox (rash)
Allergies:
Diagnostic Lab Data: None needed
CDC 'Split Type':

Write-up: Fever to 105 this morning, decreased to 100.4 after several hours, no treatment given. Also listless.


Changed on 9/14/2017

VAERS ID: 634198 Before After
VAERS Form:(blank) 1
Age:5.0
Gender:Male
Location:Vermont
Vaccinated:2016-05-02
Onset:2016-05-02
Submitted:2016-05-03
Entered:2016-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPV: DTAP + IPV (KINRIX) / GLAXOSMITHKLINE BIOLOGICALS H53CL / - UNK LA / IM
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD) / MERCK & CO. INC. L031098 / - UNK RA / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Listless, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
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:
Other Medications:
Current Illness: No
Preexisting Conditions: Allergy to Amox (rash)
Allergies:
Diagnostic Lab Data: None needed
CDC 'Split Type':

Write-up: Fever to 105 this morning, decreased to 100.4 after several hours, no treatment given. Also listless.


Changed on 2/14/2018

VAERS ID: 634198 Before After
VAERS Form:1
Age:5.0
Gender:Male
Location:Vermont
Vaccinated:2016-05-02
Onset:2016-05-02
Submitted:2016-05-03
Entered:2016-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPV: DTAP + IPV (KINRIX) / GLAXOSMITHKLINE BIOLOGICALS H53CL / UNK LA / IM
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD) / MERCK & CO. INC. L031098 / UNK RA / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Listless, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
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:
Other Medications:
Current Illness: No
Preexisting Conditions: Allergy to Amox (rash)
Allergies:
Diagnostic Lab Data: None needed
CDC 'Split Type':

Write-up: Fever to 105 this morning, decreased to 100.4 after several hours, no treatment given. Also listless.


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http://medalerts.org/vaersdb/findfield.php?IDNUMBER=634198&WAYBACKHISTORY=ON


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