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History of Changes from the VAERS Wayback Machine |
VAERS ID: | 25016 |
VAERS Form: | |
Age: | 0.3 |
Sex: | Female |
Location: | Georgia |
Vaccinated: | 1986-02-09 |
Onset: | 1986-02-09 |
Submitted: | 0000-00-00 |
Entered: | 1990-07-10 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTP: TRI-IMMUNOL / LEDERLE | - / - | - / - |
Administered by: Private Purchased by: Unknown
Symptoms: FEVER, MENTAL RETARD, CONVULS GRAND MAL, EEG ABNORM
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: initially all lab data WNL; EEG normal, however over period 1986-1988 EEG has turned markedly abnormal, all lab studies WNL
CDC 'Split Type':
Write-up: 4 mon. infant given DTP 6Feb86- no problems until 9FEB86 awoke w/ fever 103F seen by MD normal exam. 18 hrs later generalized tonic-clonic seizure thought to be febrile, 2nd seizure 17Mar86, 3rd 3Apr86, child has developmental delay.
Vaccinated: | 1986-02-09 |
Onset: | 1986-02-09 |
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 | - / - | - / - |
Administered by: Private Purchased by: Unknown
Symptoms: Electroencephalogram abnormal, Grand mal convulsion, Mental retardation severity unspecified, Pyrexia, FEVER, MENTAL RETARD, CONVULS GRAND MAL, EEG ABNORM
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: initially all lab data WNL; EEG normal, however over period 1986-1988 EEG has turned markedly abnormal, all lab studies WNL
CDC 'Split Type': (blank) 8902823.01
Write-up: 4 mon. infant given DTP 6Feb86- no problems until 9FEB86 awoke w/ fever 103F seen by MD normal exam. 18 hrs later generalized tonic-clonic seizure thought to be febrile, 2nd seizure 17Mar86, 3rd 3Apr86, child has developmental delay.
Vaccinated: | 1986-02-09 |
Onset: | 1986-02-09 |
Submitted: | 0000-00-00 |
Entered: | 1990-07-02 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES | - / - | - / - |
Administered by: Private Unknown Purchased by: Unknown
Symptoms: Electroencephalogram abnormal, Grand mal convulsion, Mental retardation severity unspecified, Pyrexia
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: initially all lab data WNL; EEG normal, however over period 1986-1988 EEG has turned markedly abnormal, all lab studies WNL
CDC 'Split Type': 8902823.01 890282301
Write-up: 4 mon. infant given DTP 6Feb86- no problems until 9FEB86 awoke w/ fever 103F seen by MD normal exam. 18 hrs later generalized tonic-clonic seizure thought to be febrile, 2nd seizure 17Mar86, 3rd 3Apr86, child has developmental delay.
Vaccinated: | 1986-02-09 |
Onset: | 1986-02-09 |
Submitted: | 0000-00-00 |
Entered: | 1990-07-02 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES | - / - UNK | - / - |
Administered by: Unknown Purchased by: Unknown
Symptoms: Electroencephalogram abnormal, Grand mal convulsion, Mental retardation severity unspecified, Pyrexia
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: initially all lab data WNL; EEG normal, however over period 1986-1988 EEG has turned markedly abnormal, all lab studies WNL
CDC 'Split Type': 890282301
Write-up: 4 mon. infant given DTP 6Feb86- no problems until 9FEB86 awoke w/ fever 103F seen by MD normal exam. 18 hrs later generalized tonic-clonic seizure thought to be febrile, 2nd seizure 17Mar86, 3rd 3Apr86, child has developmental delay.
Vaccinated: | 1986-02-09 |
Onset: | 1986-02-09 |
Submitted: | 0000-00-00 |
Entered: | 1990-07-02 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES | - / UNK | - / - |
Administered by: Unknown Purchased by: Unknown
Symptoms: Electroencephalogram abnormal, Grand mal convulsion, Mental retardation severity unspecified, Pyrexia
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: initially all lab data WNL; EEG normal, however over period 1986-1988 EEG has turned markedly abnormal, all lab studies WNL
CDC 'Split Type': 890282301
Write-up: 4 mon. infant given DTP 6Feb86- no problems until 9FEB86 awoke w/ fever 103F seen by MD normal exam. 18 hrs later generalized tonic-clonic seizure thought to be febrile, 2nd seizure 17Mar86, 3rd 3Apr86, child has developmental delay.
Vaccinated: | 1986-02-09 |
Onset: | 1986-02-09 |
Submitted: | 0000-00-00 |
Entered: | 1990-07-02 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES | - / UNK | - / - |
Administered by: Unknown Purchased by: Unknown
Symptoms: Electroencephalogram abnormal, Grand mal convulsion, Mental retardation severity unspecified, Pyrexia
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: initially all lab data WNL; EEG normal, however over period 1986-1988 EEG has turned markedly abnormal, all lab studies WNL
CDC 'Split Type': 890282301
Write-up: 4 mon. infant given DTP 6Feb86- no problems until 9FEB86 awoke w/ fever 103F seen by MD normal exam. 18 hrs later generalized tonic-clonic seizure thought to be febrile, 2nd seizure 17Mar86, 3rd 3Apr86, child has developmental delay.
Vaccinated: | 1986-02-09 |
Onset: | 1986-02-09 |
Submitted: | 0000-00-00 |
Entered: | 1990-07-02 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES | - / UNK | - / - |
Administered by: Unknown Purchased by: Unknown
Symptoms: Electroencephalogram abnormal, Grand mal convulsion, Mental retardation severity unspecified, Pyrexia
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: initially all lab data WNL; EEG normal, however over period 1986-1988 EEG has turned markedly abnormal, all lab studies WNL
CDC 'Split Type': 890282301
Write-up: 4 mon. infant given DTP 6Feb86- no problems until 9FEB86 awoke w/ fever 103F seen by MD normal exam. 18 hrs later generalized tonic-clonic seizure thought to be febrile, 2nd seizure 17Mar86, 3rd 3Apr86, child has developmental delay.
Vaccinated: | 1986-02-09 |
Onset: | 1986-02-09 |
Submitted: | 0000-00-00 |
Entered: | 1990-07-02 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES | - / UNK | - / - |
Administered by: Unknown Purchased by: Unknown
Symptoms: Electroencephalogram abnormal, Grand mal convulsion, Mental retardation severity unspecified, Pyrexia
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: initially all lab data WNL; EEG normal, however over period 1986-1988 EEG has turned markedly abnormal, all lab studies WNL
CDC 'Split Type': 890282301
Write-up: 4 mon. infant given DTP 6Feb86- no problems until 9FEB86 awoke w/ fever 103F seen by MD normal exam. 18 hrs later generalized tonic-clonic seizure thought to be febrile, 2nd seizure 17Mar86, 3rd 3Apr86, child has developmental delay.
Vaccinated: | 1986-02-09 |
Onset: | 1986-02-09 |
Submitted: | 0000-00-00 |
Entered: | 1990-07-02 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES | - / UNK | - / - |
Administered by: Unknown Purchased by: Unknown
Symptoms: Electroencephalogram abnormal, Grand mal convulsion, Mental retardation severity unspecified, Pyrexia
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: initially all lab data WNL; EEG normal, however over period 1986-1988 EEG has turned markedly abnormal, all lab studies WNL
CDC 'Split Type': 890282301
Write-up: 4 mon. infant given DTP 6Feb86- no problems until 9FEB86 awoke w/ fever 103F seen by MD normal exam. 18 hrs later generalized tonic-clonic seizure thought to be febrile, 2nd seizure 17Mar86, 3rd 3Apr86, child has developmental delay.
Vaccinated: | 1986-02-09 |
Onset: | 1986-02-09 |
Submitted: | 0000-00-00 |
Entered: | 1990-07-02 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES | - / UNK | - / - |
Administered by: Unknown Purchased by: Unknown
Symptoms: Electroencephalogram abnormal, Grand mal convulsion, Mental retardation severity unspecified, Pyrexia
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: initially all lab data WNL; EEG normal, however over period 1986-1988 EEG has turned markedly abnormal, all lab studies WNL
CDC 'Split Type': 890282301
Write-up: 4 mon. infant given DTP 6Feb86- no problems until 9FEB86 awoke w/ fever 103F seen by MD normal exam. 18 hrs later generalized tonic-clonic seizure thought to be febrile, 2nd seizure 17Mar86, 3rd 3Apr86, child has developmental delay.
Vaccinated: | 1986-02-09 |
Onset: | 1986-02-09 |
Submitted: | 0000-00-00 |
Entered: | 1990-07-02 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES | - / UNK | - / - |
Administered by: Unknown Purchased by: Unknown
Symptoms: Electroencephalogram abnormal, Grand mal convulsion, Mental retardation severity unspecified, Pyrexia
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: initially all lab data WNL; EEG normal, however over period 1986-1988 EEG has turned markedly abnormal, all lab studies WNL
CDC 'Split Type': 890282301
Write-up: 4 mon. infant given DTP 6Feb86- no problems until 9FEB86 awoke w/ fever 103F seen by MD normal exam. 18 hrs later generalized tonic-clonic seizure thought to be febrile, 2nd seizure 17Mar86, 3rd 3Apr86, child has developmental delay.
Link To This Search Result:
https://medalerts.org/vaersdb/findfield.php?IDNUMBER=25016&WAYBACKHISTORY=ON
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