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This is VAERS ID 25496

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 25496
VAERS Form:
Age:1.4
Sex:Female
Location:Georgia
Vaccinated:1990-07-04
Onset:1990-07-05
Submitted:0000-00-00
Entered:1990-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP / CONNAUGHT LABS 0F11081 / 3 LL / IM
MMR: MMR II / MSD 10205 / - LL / IM
OPV: ORIMUNE / LEDERLE 275931 / 3 - / -

Administered by: Private      Purchased by: Unknown
Symptoms: FEVER, EYES GAZE UPWARD

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: TB Tine by Lederle on 4Jul90
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: TEMP 105 F, (axillary), episode where eyes keep moving side to side for approx. 10 min. Pt alert during this. Temp in the office 101.6 F 1 day post vaccination


Changed on 12/8/2009

VAERS ID: 25496 Before After
VAERS Form:
Age:1.4 1.3
Sex:Female
Location:Georgia
Vaccinated:1990-07-04
Onset:1990-07-05
Submitted:0000-00-00
Entered:1990-07-18 1990-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP DTP (NO BRAND NAME) / CONNAUGHT LABS CONNAUGHT LABORATORIES 0F11081 / 3 LL / IM
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 10205 / - LL / IM
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE WYETH PHARMACEUTICALS, INC 275931 / 3 - / -

Administered by: Private Unknown      Purchased by: Unknown
Symptoms: Pyrexia, Gaze palsy, FEVER, EYES GAZE UPWARD

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: TB Tine by Lederle on 4Jul90
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: TEMP 105 F, (axillary), episode where eyes keep moving side to side for approx. 10 min. Pt alert during this. Temp in the office 101.6 F 1 day post vaccination


Changed on 8/31/2010

VAERS ID: 25496 Before After
VAERS Form:
Age:1.3
Sex:Female
Location:Georgia
Vaccinated:1990-07-04
Onset:1990-07-05
Submitted:0000-00-00
Entered:1990-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0F11081 / 3 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 10205 / - LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH 275931 / 3 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Pyrexia, Gaze palsy

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: TB Tine by Lederle on 4Jul90
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: TEMP 105 F, (axillary), episode where eyes keep moving side to side for approx. 10 min. Pt alert during this. Temp in the office 101.6 F 1 day post vaccination


Changed on 9/14/2017

VAERS ID: 25496 Before After
VAERS Form:(blank) 1
Age:1.3
Sex:Female
Location:Georgia
Vaccinated:1990-07-04
Onset:1990-07-05
Submitted:0000-00-00
Entered:1990-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0F11081 / 3 4 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 10205 / - UNK LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 275931 / 3 4 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Pyrexia, Gaze palsy

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: TB Tine by Lederle on 4Jul90
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: TEMP 105 F, (axillary), episode where eyes keep moving side to side for approx. 10 min. Pt alert during this. Temp in the office 101.6 F 1 day post vaccination


Changed on 2/14/2018

VAERS ID: 25496 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Georgia
Vaccinated:1990-07-04
Onset:1990-07-05
Submitted:0000-00-00
Entered:1990-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0F11081 / 4 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 10205 / UNK LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 275931 / 4 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Pyrexia, Gaze palsy

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: TB Tine by Lederle on 4Jul90
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: TEMP 105 F, (axillary), episode where eyes keep moving side to side for approx. 10 min. Pt alert during this. Temp in the office 101.6 F 1 day post vaccination


Changed on 6/14/2018

VAERS ID: 25496 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Georgia
Vaccinated:1990-07-04
Onset:1990-07-05
Submitted:0000-00-00
Entered:1990-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0F11081 / 4 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 10205 / UNK LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 275931 / 4 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Pyrexia, Gaze palsy

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: TB Tine by Lederle on 4Jul90
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: TEMP 105 F, (axillary), episode where eyes keep moving side to side for approx. 10 min. Pt alert during this. Temp in the office 101.6 F 1 day post vaccination


Changed on 8/14/2018

VAERS ID: 25496 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Georgia
Vaccinated:1990-07-04
Onset:1990-07-05
Submitted:0000-00-00
Entered:1990-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0F11081 / 4 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 10205 / UNK LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 275931 / 4 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Pyrexia, Gaze palsy

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: TB Tine by Lederle on 4Jul90
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: TEMP 105 F, (axillary), episode where eyes keep moving side to side for approx. 10 min. Pt alert during this. Temp in the office 101.6 F 1 day post vaccination


Changed on 9/14/2018

VAERS ID: 25496 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Georgia
Vaccinated:1990-07-04
Onset:1990-07-05
Submitted:0000-00-00
Entered:1990-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0F11081 / 4 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 10205 / UNK LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 275931 / 4 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Pyrexia, Gaze palsy

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: TB Tine by Lederle on 4Jul90
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: TEMP 105 F, (axillary), episode where eyes keep moving side to side for approx. 10 min. Pt alert during this. Temp in the office 101.6 F 1 day post vaccination


Changed on 10/14/2018

VAERS ID: 25496 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Georgia
Vaccinated:1990-07-04
Onset:1990-07-05
Submitted:0000-00-00
Entered:1990-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0F11081 / 4 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 10205 / UNK LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 275931 / 4 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Pyrexia, Gaze palsy

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: TB Tine by Lederle on 4Jul90
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: TEMP 105 F, (axillary), episode where eyes keep moving side to side for approx. 10 min. Pt alert during this. Temp in the office 101.6 F 1 day post vaccination

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=25496&WAYBACKHISTORY=ON


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