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This is VAERS ID 25154

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 25154
VAERS Form:
Age:0.2
Sex:Female
Location:New Jersey
Vaccinated:1989-11-27
Onset:1989-11-27
Submitted:0000-00-00
Entered:1990-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 259966 / - - / IM
OPV: ORIMUNE / LEDERLE - / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: FEVER, SCREAMING SYND

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: N/A
Current Illness:
Preexisting Conditions: N/A
Allergies:
Diagnostic Lab Data: CT (BRAIN)-NORMAL; EEG-NORMAL; NEURO WATCH-NORMAL
CDC 'Split Type':

Write-up: AFTER 1ST IMMUN DEVELOPED FEVER AND PERSISTANT SCREAMING FOR 3 HRS. HOSPITALIZED FOR ABSERVATION. DOING FINE AT TIME OF REPORT


Changed on 12/8/2009

VAERS ID: 25154 Before After
VAERS Form:
Age:0.2
Sex:Female
Location:New Jersey
Vaccinated:1989-11-27
Onset:1989-11-27
Submitted:0000-00-00
Entered:1990-07-18 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL DTP (TRI-IMMUNOL) / LEDERLE LEDERLE LABORATORIES 259966 / - - / IM
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES - / - - / -

Administered by: Private      Purchased by: Unknown Private
Symptoms: Pyrexia, Screaming, FEVER, SCREAMING SYND

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: N/A
Current Illness:
Preexisting Conditions: N/A
Allergies:
Diagnostic Lab Data: CT (BRAIN)-NORMAL; EEG-NORMAL; NEURO WATCH-NORMAL
CDC 'Split Type': (blank) 8902842.01

Write-up: AFTER 1ST IMMUN DEVELOPED FEVER AND PERSISTANT SCREAMING FOR 3 HRS. HOSPITALIZED FOR ABSERVATION. DOING FINE AT TIME OF REPORT


Changed on 5/14/2017

VAERS ID: 25154 Before After
VAERS Form:
Age:0.2
Sex:Female
Location:New Jersey
Vaccinated:1989-11-27
Onset:1989-11-27
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 259966 / - - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH - / - - / -

Administered by: Private      Purchased by: Private
Symptoms: Pyrexia, Screaming

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: N/A
Current Illness:
Preexisting Conditions: N/A
Allergies:
Diagnostic Lab Data: CT (BRAIN)-NORMAL; EEG-NORMAL; NEURO WATCH-NORMAL
CDC 'Split Type': 8902842.01

Write-up: AFTER 1ST IMMUN DEVELOPED FEVER AND PERSISTANT SCREAMING FOR 3 HRS. HOSPITALIZED FOR ABSERVATION. DOING FINE AT TIME OF REPORT


Changed on 9/14/2017

VAERS ID: 25154 Before After
VAERS Form:(blank) 1
Age:0.2
Sex:Female
Location:New Jersey
Vaccinated:1989-11-27
Onset:1989-11-27
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 259966 / - UNK - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH - / - UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Pyrexia, Screaming

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: N/A
Current Illness:
Preexisting Conditions: N/A
Allergies:
Diagnostic Lab Data: CT (BRAIN)-NORMAL; EEG-NORMAL; NEURO WATCH-NORMAL
CDC 'Split Type': 8902842.01

Write-up: AFTER 1ST IMMUN DEVELOPED FEVER AND PERSISTANT SCREAMING FOR 3 HRS. HOSPITALIZED FOR ABSERVATION. DOING FINE AT TIME OF REPORT


Changed on 2/14/2018

VAERS ID: 25154 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:New Jersey
Vaccinated:1989-11-27
Onset:1989-11-27
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 259966 / UNK - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH - / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Pyrexia, Screaming

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: N/A
Current Illness:
Preexisting Conditions: N/A
Allergies:
Diagnostic Lab Data: CT (BRAIN)-NORMAL; EEG-NORMAL; NEURO WATCH-NORMAL
CDC 'Split Type': 8902842.01

Write-up: AFTER 1ST IMMUN DEVELOPED FEVER AND PERSISTANT SCREAMING FOR 3 HRS. HOSPITALIZED FOR ABSERVATION. DOING FINE AT TIME OF REPORT


Changed on 6/14/2018

VAERS ID: 25154 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:New Jersey
Vaccinated:1989-11-27
Onset:1989-11-27
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 259966 / UNK - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH - / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Pyrexia, Screaming

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: N/A
Current Illness:
Preexisting Conditions: N/A
Allergies:
Diagnostic Lab Data: CT (BRAIN)-NORMAL; EEG-NORMAL; NEURO WATCH-NORMAL
CDC 'Split Type': 8902842.01

Write-up: AFTER 1ST IMMUN DEVELOPED FEVER AND PERSISTANT SCREAMING FOR 3 HRS. HOSPITALIZED FOR ABSERVATION. DOING FINE AT TIME OF REPORT


Changed on 8/14/2018

VAERS ID: 25154 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:New Jersey
Vaccinated:1989-11-27
Onset:1989-11-27
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 259966 / UNK - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH - / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Pyrexia, Screaming

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: N/A
Current Illness:
Preexisting Conditions: N/A
Allergies:
Diagnostic Lab Data: CT (BRAIN)-NORMAL; EEG-NORMAL; NEURO WATCH-NORMAL
CDC 'Split Type': 8902842.01

Write-up: AFTER 1ST IMMUN DEVELOPED FEVER AND PERSISTANT SCREAMING FOR 3 HRS. HOSPITALIZED FOR ABSERVATION. DOING FINE AT TIME OF REPORT


Changed on 9/14/2018

VAERS ID: 25154 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:New Jersey
Vaccinated:1989-11-27
Onset:1989-11-27
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 259966 / UNK - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH - / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Pyrexia, Screaming

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: N/A
Current Illness:
Preexisting Conditions: N/A
Allergies:
Diagnostic Lab Data: CT (BRAIN)-NORMAL; EEG-NORMAL; NEURO WATCH-NORMAL
CDC 'Split Type': 8902842.01

Write-up: AFTER 1ST IMMUN DEVELOPED FEVER AND PERSISTANT SCREAMING FOR 3 HRS. HOSPITALIZED FOR ABSERVATION. DOING FINE AT TIME OF REPORT


Changed on 10/14/2018

VAERS ID: 25154 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:New Jersey
Vaccinated:1989-11-27
Onset:1989-11-27
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 259966 / UNK - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH - / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Pyrexia, Screaming

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: N/A
Current Illness:
Preexisting Conditions: N/A
Allergies:
Diagnostic Lab Data: CT (BRAIN)-NORMAL; EEG-NORMAL; NEURO WATCH-NORMAL
CDC 'Split Type': 8902842.01

Write-up: AFTER 1ST IMMUN DEVELOPED FEVER AND PERSISTANT SCREAMING FOR 3 HRS. HOSPITALIZED FOR ABSERVATION. DOING FINE AT TIME OF REPORT

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