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This is VAERS ID 25012

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 25012
VAERS Form:
Age:0.2
Sex:Male
Location:Wisconsin
Vaccinated:1989-10-20
Onset:1989-10-23
Submitted:0000-00-00
Entered:1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 253963 / - RL / IM
OPV: ORIMUNE / LEDERLE - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: HYPOTONIA, MONOPLEGIA, NEUROPATHY

Life Threatening? No
Birth Defect? No
Died? No
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: xrays of left shoulder, clavicle, humerus & forearm - WNL
CDC 'Split Type':

Write-up: 3 days /p immun. infant only able to move fingers of left arm, no tone in arm. Immun. given in Right thigh/buttocks. Mononeuropathy left upper extremity.


Changed on 12/8/2009

VAERS ID: 25012 Before After
VAERS Form:
Age:0.2
Sex:Male
Location:Wisconsin
Vaccinated:1989-10-20
Onset:1989-10-23
Submitted:0000-00-00
Entered:1990-07-10 1990-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL DTP (TRI-IMMUNOL) / LEDERLE LEDERLE LABORATORIES 253963 / - RL / IM
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Hypotonia, Monoplegia, Neuropathy, HYPOTONIA, MONOPLEGIA, NEUROPATHY

Life Threatening? No
Birth Defect? No
Died? No
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: xrays of left shoulder, clavicle, humerus & forearm - WNL
CDC 'Split Type': (blank) 890255101

Write-up: 3 days /p immun. infant only able to move fingers of left arm, no tone in arm. Immun. given in Right thigh/buttocks. Mononeuropathy left upper extremity.


Changed on 5/14/2017

VAERS ID: 25012 Before After
VAERS Form:
Age:0.2
Sex:Male
Location:Wisconsin
Vaccinated:1989-10-20
Onset:1989-10-23
Submitted:0000-00-00
Entered:1990-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 253963 / - RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Hypotonia, Monoplegia, Neuropathy

Life Threatening? No
Birth Defect? No
Died? No
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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: xrays of left shoulder, clavicle, humerus & forearm - WNL
CDC 'Split Type': 890255101

Write-up: 3 days /p immun. infant only able to move fingers of left arm, no tone in arm. Immun. given in Right thigh/buttocks. Mononeuropathy left upper extremity.


Changed on 9/14/2017

VAERS ID: 25012 Before After
VAERS Form:(blank) 1
Age:0.2
Sex:Male
Location:Wisconsin
Vaccinated:1989-10-20
Onset:1989-10-23
Submitted:0000-00-00
Entered:1990-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 253963 / - UNK RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH - / - UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Hypotonia, Monoplegia, Neuropathy

Life Threatening? No
Birth Defect? No
Died? No
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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: xrays of left shoulder, clavicle, humerus & forearm - WNL
CDC 'Split Type': 890255101

Write-up: 3 days /p immun. infant only able to move fingers of left arm, no tone in arm. Immun. given in Right thigh/buttocks. Mononeuropathy left upper extremity.


Changed on 2/14/2018

VAERS ID: 25012 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Wisconsin
Vaccinated:1989-10-20
Onset:1989-10-23
Submitted:0000-00-00
Entered:1990-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 253963 / UNK RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Hypotonia, Monoplegia, Neuropathy

Life Threatening? No
Birth Defect? No
Died? No
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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: xrays of left shoulder, clavicle, humerus & forearm - WNL
CDC 'Split Type': 890255101

Write-up: 3 days /p immun. infant only able to move fingers of left arm, no tone in arm. Immun. given in Right thigh/buttocks. Mononeuropathy left upper extremity.


Changed on 6/14/2018

VAERS ID: 25012 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Wisconsin
Vaccinated:1989-10-20
Onset:1989-10-23
Submitted:0000-00-00
Entered:1990-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 253963 / UNK RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Hypotonia, Monoplegia, Neuropathy

Life Threatening? No
Birth Defect? No
Died? No
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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: xrays of left shoulder, clavicle, humerus & forearm - WNL
CDC 'Split Type': 890255101

Write-up: 3 days /p immun. infant only able to move fingers of left arm, no tone in arm. Immun. given in Right thigh/buttocks. Mononeuropathy left upper extremity.


Changed on 8/14/2018

VAERS ID: 25012 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Wisconsin
Vaccinated:1989-10-20
Onset:1989-10-23
Submitted:0000-00-00
Entered:1990-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 253963 / UNK RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Hypotonia, Monoplegia, Neuropathy

Life Threatening? No
Birth Defect? No
Died? No
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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: xrays of left shoulder, clavicle, humerus & forearm - WNL
CDC 'Split Type': 890255101

Write-up: 3 days /p immun. infant only able to move fingers of left arm, no tone in arm. Immun. given in Right thigh/buttocks. Mononeuropathy left upper extremity.


Changed on 9/14/2018

VAERS ID: 25012 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Wisconsin
Vaccinated:1989-10-20
Onset:1989-10-23
Submitted:0000-00-00
Entered:1990-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 253963 / UNK RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Hypotonia, Monoplegia, Neuropathy

Life Threatening? No
Birth Defect? No
Died? No
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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: xrays of left shoulder, clavicle, humerus & forearm - WNL
CDC 'Split Type': 890255101

Write-up: 3 days /p immun. infant only able to move fingers of left arm, no tone in arm. Immun. given in Right thigh/buttocks. Mononeuropathy left upper extremity.


Changed on 10/14/2018

VAERS ID: 25012 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Wisconsin
Vaccinated:1989-10-20
Onset:1989-10-23
Submitted:0000-00-00
Entered:1990-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 253963 / UNK RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Hypotonia, Monoplegia, Neuropathy

Life Threatening? No
Birth Defect? No
Died? No
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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: xrays of left shoulder, clavicle, humerus & forearm - WNL
CDC 'Split Type': 890255101

Write-up: 3 days /p immun. infant only able to move fingers of left arm, no tone in arm. Immun. given in Right thigh/buttocks. Mononeuropathy left upper extremity.

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