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This is VAERS ID 150892

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 150892
VAERS Form:
Age:1.4
Sex:Male
Location:California
Vaccinated:1997-11-01
Onset:1998-08-01
Submitted:2000-04-04
Entered:2000-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
OPV: ORIMUNE / LEDERLE - / - - / PO

Administered by: Other      Purchased by: Unknown
Symptoms: NEOPL CNS, INFECT VIRAL

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1999-01-31
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type':

Write-up: Pt received vax in November 1997. In August 1998, pt allegedly was diagnosed with medulloblastoma. Allegedly the pt underwent two surgeries to remove the tumor and was administered chemotherapy. On 1/31/99, he died. Allegedly his brain tissue revealed the"presence of Simian Virus-40.


Changed on 12/8/2009

VAERS ID: 150892 Before After
VAERS Form:
Age:1.4
Sex:Male
Location:California
Vaccinated:1997-11-01
Onset:1998-08-01
Submitted:2000-04-04
Entered:2000-04-12 2000-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES - / - - / PO

Administered by: Other      Purchased by: Unknown Other
Symptoms: Laboratory test abnormal, Viral infection, Brain neoplasm, NEOPL CNS, INFECT VIRAL

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1999-01-31
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK Virus tissue specimen test positive 4/25/02: microscopic examination of brain tissue containing foci of round poorly differentiated tumor cells. Results: tumor tissue: very strong band visualized. Fooled section of the adjacent brain tissue
CDC 'Split Type': (blank) HQ2032103APR2000

Write-up: Pt received vax in November 1997. In August 1998, pt allegedly was diagnosed with medulloblastoma. Allegedly the pt underwent two surgeries to remove the tumor and was administered chemotherapy. On 1/31/99, he died. Allegedly his brain tissue revealed the"presence the presence of Simian Virus-40. Additional info received on 2/24/03 from attorney for consumer contained one physician''s pathology analysisi of brain tissue. A legal complaint was received from an attorney alleging that a 25 month old male recieved Orimune in November 1997 that was "improperly manufactured and which contained contaminants including, but not limited to SV40 which caused the development of brain tumors that ultimately were a direct and proximate cause of his death." The child was diagnosed with medulloblastoma in August 1998. According to the legal complaint, the pt underwent two surgeries to remove the tumor and was administered chemotherapy. On 1/31/99, he died. On 4/25/02, a microscopic examination of brain tissue revealed DNA sequences specific for Simian Virus-40 (SV40) present in the tumor cells but they were absent in the adjacent non-malignant brain tissue.


Changed on 5/14/2017

VAERS ID: 150892 Before After
VAERS Form:
Age:1.4
Sex:Male
Location:California
Vaccinated:1997-11-01
Onset:1998-08-01
Submitted:2000-04-04
Entered:2000-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH - / - - / PO

Administered by: Other      Purchased by: Other
Symptoms: Laboratory test abnormal, Viral infection, Brain neoplasm

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1999-01-31
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: Virus tissue specimen test positive 4/25/02: microscopic examination of brain tissue containing foci of round poorly differentiated tumor cells. Results: tumor tissue: very strong band visualized. Fooled section of the adjacent brain tissue were negative for SV40 sequences. Interpretation: DNA sequences specific for SV40, were present in the tumor cells but were absent in the adjacent non-malignant brain tissue. Autopsy results: medulloblastoma
CDC 'Split Type': HQ2032103APR2000

Write-up: Pt received vax in November 1997. In August 1998, pt allegedly was diagnosed with medulloblastoma. Allegedly the pt underwent two surgeries to remove the tumor and was administered chemotherapy. On 1/31/99, he died. Allegedly his brain tissue revealed the presence of Simian Virus-40. Additional info received on 2/24/03 from attorney for consumer contained one physician''s pathology analysisi of brain tissue. A legal complaint was received from an attorney alleging that a 25 month old male recieved Orimune in November 1997 that was "improperly manufactured and which contained contaminants including, but not limited to SV40 which caused the development of brain tumors that ultimately were a direct and proximate cause of his death." The child was diagnosed with medulloblastoma in August 1998. According to the legal complaint, the pt underwent two surgeries to remove the tumor and was administered chemotherapy. On 1/31/99, he died. On 4/25/02, a microscopic examination of brain tissue revealed DNA sequences specific for Simian Virus-40 (SV40) present in the tumor cells but they were absent in the adjacent non-malignant brain tissue.


Changed on 9/14/2017

VAERS ID: 150892 Before After
VAERS Form:(blank) 1
Age:1.4
Sex:Male
Location:California
Vaccinated:1997-11-01
Onset:1998-08-01
Submitted:2000-04-04
Entered:2000-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH - / - UNK - MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Laboratory test abnormal, Viral infection, Brain neoplasm

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1999-01-31
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: Virus tissue specimen test positive 4/25/02: microscopic examination of brain tissue containing foci of round poorly differentiated tumor cells. Results: tumor tissue: very strong band visualized. Fooled section of the adjacent brain tissue were negative for SV40 sequences. Interpretation: DNA sequences specific for SV40, were present in the tumor cells but were absent in the adjacent non-malignant brain tissue. Autopsy results: medulloblastoma
CDC 'Split Type': HQ2032103APR2000

Write-up: Pt received vax in November 1997. In August 1998, pt allegedly was diagnosed with medulloblastoma. Allegedly the pt underwent two surgeries to remove the tumor and was administered chemotherapy. On 1/31/99, he died. Allegedly his brain tissue revealed the presence of Simian Virus-40. Additional info received on 2/24/03 from attorney for consumer contained one physician''s pathology analysisi of brain tissue. A legal complaint was received from an attorney alleging that a 25 month old male recieved Orimune in November 1997 that was "improperly manufactured and which contained contaminants including, but not limited to SV40 which caused the development of brain tumors that ultimately were a direct and proximate cause of his death." The child was diagnosed with medulloblastoma in August 1998. According to the legal complaint, the pt underwent two surgeries to remove the tumor and was administered chemotherapy. On 1/31/99, he died. On 4/25/02, a microscopic examination of brain tissue revealed DNA sequences specific for Simian Virus-40 (SV40) present in the tumor cells but they were absent in the adjacent non-malignant brain tissue.


Changed on 2/14/2018

VAERS ID: 150892 Before After
VAERS Form:1
Age:1.4
Sex:Male
Location:California
Vaccinated:1997-11-01
Onset:1998-08-01
Submitted:2000-04-04
Entered:2000-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH - / UNK MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Laboratory test abnormal, Viral infection, Brain neoplasm

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1999-01-31
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: Virus tissue specimen test positive 4/25/02: microscopic examination of brain tissue containing foci of round poorly differentiated tumor cells. Results: tumor tissue: very strong band visualized. Fooled section of the adjacent brain tissue were negative for SV40 sequences. Interpretation: DNA sequences specific for SV40, were present in the tumor cells but were absent in the adjacent non-malignant brain tissue. Autopsy results: medulloblastoma
CDC 'Split Type': HQ2032103APR2000

Write-up: Pt received vax in November 1997. In August 1998, pt allegedly was diagnosed with medulloblastoma. Allegedly the pt underwent two surgeries to remove the tumor and was administered chemotherapy. On 1/31/99, he died. Allegedly his brain tissue revealed the presence of Simian Virus-40. Additional info received on 2/24/03 from attorney for consumer contained one physician''s pathology analysisi of brain tissue. A legal complaint was received from an attorney alleging that a 25 month old male recieved Orimune in November 1997 that was "improperly manufactured and which contained contaminants including, but not limited to SV40 which caused the development of brain tumors that ultimately were a direct and proximate cause of his death." The child was diagnosed with medulloblastoma in August 1998. According to the legal complaint, the pt underwent two surgeries to remove the tumor and was administered chemotherapy. On 1/31/99, he died. On 4/25/02, a microscopic examination of brain tissue revealed DNA sequences specific for Simian Virus-40 (SV40) present in the tumor cells but they were absent in the adjacent non-malignant brain tissue.


Changed on 6/14/2018

VAERS ID: 150892 Before After
VAERS Form:1
Age:1.4
Sex:Male
Location:California
Vaccinated:1997-11-01
Onset:1998-08-01
Submitted:2000-04-04
Entered:2000-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH - / UNK MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Laboratory test abnormal, Viral infection, Brain neoplasm

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1999-01-31
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: Virus tissue specimen test positive 4/25/02: microscopic examination of brain tissue containing foci of round poorly differentiated tumor cells. Results: tumor tissue: very strong band visualized. Fooled section of the adjacent brain tissue were negative for SV40 sequences. Interpretation: DNA sequences specific for SV40, were present in the tumor cells but were absent in the adjacent non-malignant brain tissue. Autopsy results: medulloblastoma
CDC 'Split Type': HQ2032103APR2000

Write-up: Pt received vax in November 1997. In August 1998, pt allegedly was diagnosed with medulloblastoma. Allegedly the pt underwent two surgeries to remove the tumor and was administered chemotherapy. On 1/31/99, he died. Allegedly his brain tissue revealed the presence of Simian Virus-40. Additional info received on 2/24/03 from attorney for consumer contained one physician''s pathology analysisi of brain tissue. A legal complaint was received from an attorney alleging that a 25 month old male recieved Orimune in November 1997 that was "improperly manufactured and which contained contaminants including, but not limited to SV40 which caused the development of brain tumors that ultimately were a direct and proximate cause of his death." The child was diagnosed with medulloblastoma in August 1998. According to the legal complaint, the pt underwent two surgeries to remove the tumor and was administered chemotherapy. On 1/31/99, he died. On 4/25/02, a microscopic examination of brain tissue revealed DNA sequences specific for Simian Virus-40 (SV40) present in the tumor cells but they were absent in the adjacent non-malignant brain tissue.


Changed on 8/14/2018

VAERS ID: 150892 Before After
VAERS Form:1
Age:1.4
Sex:Male
Location:California
Vaccinated:1997-11-01
Onset:1998-08-01
Submitted:2000-04-04
Entered:2000-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH - / UNK MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Laboratory test abnormal, Viral infection, Brain neoplasm

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1999-01-31
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: Virus tissue specimen test positive 4/25/02: microscopic examination of brain tissue containing foci of round poorly differentiated tumor cells. Results: tumor tissue: very strong band visualized. Fooled section of the adjacent brain tissue were negative for SV40 sequences. Interpretation: DNA sequences specific for SV40, were present in the tumor cells but were absent in the adjacent non-malignant brain tissue. Autopsy results: medulloblastoma
CDC 'Split Type': HQ2032103APR2000

Write-up: Pt received vax in November 1997. In August 1998, pt allegedly was diagnosed with medulloblastoma. Allegedly the pt underwent two surgeries to remove the tumor and was administered chemotherapy. On 1/31/99, he died. Allegedly his brain tissue revealed the presence of Simian Virus-40. Additional info received on 2/24/03 from attorney for consumer contained one physician''s pathology analysisi of brain tissue. A legal complaint was received from an attorney alleging that a 25 month old male recieved Orimune in November 1997 that was "improperly manufactured and which contained contaminants including, but not limited to SV40 which caused the development of brain tumors that ultimately were a direct and proximate cause of his death." The child was diagnosed with medulloblastoma in August 1998. According to the legal complaint, the pt underwent two surgeries to remove the tumor and was administered chemotherapy. On 1/31/99, he died. On 4/25/02, a microscopic examination of brain tissue revealed DNA sequences specific for Simian Virus-40 (SV40) present in the tumor cells but they were absent in the adjacent non-malignant brain tissue.


Changed on 9/14/2018

VAERS ID: 150892 Before After
VAERS Form:1
Age:1.4
Sex:Male
Location:California
Vaccinated:1997-11-01
Onset:1998-08-01
Submitted:2000-04-04
Entered:2000-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH - / UNK MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Laboratory test abnormal, Viral infection, Brain neoplasm

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1999-01-31
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: Virus tissue specimen test positive 4/25/02: microscopic examination of brain tissue containing foci of round poorly differentiated tumor cells. Results: tumor tissue: very strong band visualized. Fooled section of the adjacent brain tissue were negative for SV40 sequences. Interpretation: DNA sequences specific for SV40, were present in the tumor cells but were absent in the adjacent non-malignant brain tissue. Autopsy results: medulloblastoma
CDC 'Split Type': HQ2032103APR2000

Write-up: Pt received vax in November 1997. In August 1998, pt allegedly was diagnosed with medulloblastoma. Allegedly the pt underwent two surgeries to remove the tumor and was administered chemotherapy. On 1/31/99, he died. Allegedly his brain tissue revealed the presence of Simian Virus-40. Additional info received on 2/24/03 from attorney for consumer contained one physician''s pathology analysisi of brain tissue. A legal complaint was received from an attorney alleging that a 25 month old male recieved Orimune in November 1997 that was "improperly manufactured and which contained contaminants including, but not limited to SV40 which caused the development of brain tumors that ultimately were a direct and proximate cause of his death." The child was diagnosed with medulloblastoma in August 1998. According to the legal complaint, the pt underwent two surgeries to remove the tumor and was administered chemotherapy. On 1/31/99, he died. On 4/25/02, a microscopic examination of brain tissue revealed DNA sequences specific for Simian Virus-40 (SV40) present in the tumor cells but they were absent in the adjacent non-malignant brain tissue.


Changed on 10/14/2018

VAERS ID: 150892 Before After
VAERS Form:1
Age:1.4
Sex:Male
Location:California
Vaccinated:1997-11-01
Onset:1998-08-01
Submitted:2000-04-04
Entered:2000-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH - / UNK MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Laboratory test abnormal, Viral infection, Brain neoplasm

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1999-01-31
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: Virus tissue specimen test positive 4/25/02: microscopic examination of brain tissue containing foci of round poorly differentiated tumor cells. Results: tumor tissue: very strong band visualized. Fooled section of the adjacent brain tissue were negative for SV40 sequences. Interpretation: DNA sequences specific for SV40, were present in the tumor cells but were absent in the adjacent non-malignant brain tissue. Autopsy results: medulloblastoma
CDC 'Split Type': HQ2032103APR2000

Write-up: Pt received vax in November 1997. In August 1998, pt allegedly was diagnosed with medulloblastoma. Allegedly the pt underwent two surgeries to remove the tumor and was administered chemotherapy. On 1/31/99, he died. Allegedly his brain tissue revealed the presence of Simian Virus-40. Additional info received on 2/24/03 from attorney for consumer contained one physician''s pathology analysisi of brain tissue. A legal complaint was received from an attorney alleging that a 25 month old male recieved Orimune in November 1997 that was "improperly manufactured and which contained contaminants including, but not limited to SV40 which caused the development of brain tumors that ultimately were a direct and proximate cause of his death." The child was diagnosed with medulloblastoma in August 1998. According to the legal complaint, the pt underwent two surgeries to remove the tumor and was administered chemotherapy. On 1/31/99, he died. On 4/25/02, a microscopic examination of brain tissue revealed DNA sequences specific for Simian Virus-40 (SV40) present in the tumor cells but they were absent in the adjacent non-malignant brain tissue.

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