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This is VAERS ID 25515

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 25515
VAERS Form:
Age:
Sex:Male
Location:Arizona
Vaccinated:1990-06-20
Onset:1990-06-20
Submitted:0000-00-00
Entered:1990-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: UNK. DTP / UNCLASSIFIED - / - - / -
HIBV: UNK. HAEMOPHILUS B / UNCLASSIFIED - / - - / -
MMR: UNK. MEASLES, MUMPS & RUBELLA VIRUS LIVE / UNCLASSIFIED - / - - / -
OPV: UNK. POLIOVIRUS LIVE ORAL TRIVALENT / UNCLASSIFIED - / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: FEVER

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: Suprax 100 mg qd
Current Illness:
Preexisting Conditions: chronic otitis media on Abx suppression
Allergies:
Diagnostic Lab Data: exam- no source of infection, urine - neg.
CDC 'Split Type':

Write-up: Temp 105 F, slow to come down with Tylenol & baths. Immunization given in a.m. Rxn in p.m. of same day. Had gotten DPT/OPV/MMR/HIB vaccine that day


Changed on 12/8/2009

VAERS ID: 25515 Before After
VAERS Form:
Age:
Sex:Male
Location:Arizona
Vaccinated:1990-06-20
Onset:1990-06-20
Submitted:0000-00-00
Entered:1990-07-19 1990-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: UNK. DTP DTP (NO BRAND NAME) / UNCLASSIFIED UNKNOWN MANUFACTURER - / - - / -
HIBV: UNK. HAEMOPHILUS B HIB (NO BRAND NAME) / UNCLASSIFIED UNKNOWN MANUFACTURER - / - - / -
MMR: UNK. MEASLES, MUMPS & RUBELLA VIRUS LIVE MEASLES + MUMPS + RUBELLA (NO BRAND NAME) / UNCLASSIFIED UNKNOWN MANUFACTURER - / - - / -
OPV: UNK. POLIOVIRUS LIVE ORAL TRIVALENT POLIO VIRUS, ORAL (NO BRAND NAME) / UNCLASSIFIED UNKNOWN MANUFACTURER - / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Pyrexia, FEVER

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: Suprax 100 mg qd
Current Illness:
Preexisting Conditions: chronic otitis media on Abx suppression
Allergies:
Diagnostic Lab Data: exam- no source of infection, urine - neg.
CDC 'Split Type':

Write-up: Temp 105 F, slow to come down with Tylenol & baths. Immunization given in a.m. Rxn in p.m. of same day. Had gotten DPT/OPV/MMR/HIB vaccine that day


Changed on 5/14/2017

VAERS ID: 25515 Before After
VAERS Form:
Age:
Sex:Male
Location:Arizona
Vaccinated:1990-06-20
Onset:1990-06-20
Submitted:0000-00-00
Entered:1990-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Pyrexia

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: Suprax 100 mg qd
Current Illness:
Preexisting Conditions: chronic otitis media on Abx suppression
Allergies:
Diagnostic Lab Data: exam- no source of infection, urine - neg.
CDC 'Split Type':

Write-up: Temp 105 F, slow to come down with Tylenol & baths. Immunization given in a.m. Rxn in p.m. of same day. Had gotten DPT/OPV/MMR/HIB vaccine that day


Changed on 9/14/2017

VAERS ID: 25515 Before After
VAERS Form:(blank) 1
Age:
Sex:Male
Location:Arizona
Vaccinated:1990-06-20
Onset:1990-06-20
Submitted:0000-00-00
Entered:1990-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK - / -
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK - / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Pyrexia

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: Suprax 100 mg qd
Current Illness:
Preexisting Conditions: chronic otitis media on Abx suppression
Allergies:
Diagnostic Lab Data: exam- no source of infection, urine - neg.
CDC 'Split Type':

Write-up: Temp 105 F, slow to come down with Tylenol & baths. Immunization given in a.m. Rxn in p.m. of same day. Had gotten DPT/OPV/MMR/HIB vaccine that day


Changed on 2/14/2018

VAERS ID: 25515 Before After
VAERS Form:1
Age:
Sex:Male
Location:Arizona
Vaccinated:1990-06-20
Onset:1990-06-20
Submitted:0000-00-00
Entered:1990-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Pyrexia

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: Suprax 100 mg qd
Current Illness:
Preexisting Conditions: chronic otitis media on Abx suppression
Allergies:
Diagnostic Lab Data: exam- no source of infection, urine - neg.
CDC 'Split Type':

Write-up: Temp 105 F, slow to come down with Tylenol & baths. Immunization given in a.m. Rxn in p.m. of same day. Had gotten DPT/OPV/MMR/HIB vaccine that day


Changed on 6/14/2018

VAERS ID: 25515 Before After
VAERS Form:1
Age:
Sex:Male
Location:Arizona
Vaccinated:1990-06-20
Onset:1990-06-20
Submitted:0000-00-00
Entered:1990-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Pyrexia

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: Suprax 100 mg qd
Current Illness:
Preexisting Conditions: chronic otitis media on Abx suppression
Allergies:
Diagnostic Lab Data: exam- no source of infection, urine - neg.
CDC 'Split Type':

Write-up: Temp 105 F, slow to come down with Tylenol & baths. Immunization given in a.m. Rxn in p.m. of same day. Had gotten DPT/OPV/MMR/HIB vaccine that day


Changed on 8/14/2018

VAERS ID: 25515 Before After
VAERS Form:1
Age:
Sex:Male
Location:Arizona
Vaccinated:1990-06-20
Onset:1990-06-20
Submitted:0000-00-00
Entered:1990-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Pyrexia

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: Suprax 100 mg qd
Current Illness:
Preexisting Conditions: chronic otitis media on Abx suppression
Allergies:
Diagnostic Lab Data: exam- no source of infection, urine - neg.
CDC 'Split Type':

Write-up: Temp 105 F, slow to come down with Tylenol & baths. Immunization given in a.m. Rxn in p.m. of same day. Had gotten DPT/OPV/MMR/HIB vaccine that day


Changed on 9/14/2018

VAERS ID: 25515 Before After
VAERS Form:1
Age:
Sex:Male
Location:Arizona
Vaccinated:1990-06-20
Onset:1990-06-20
Submitted:0000-00-00
Entered:1990-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Pyrexia

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: Suprax 100 mg qd
Current Illness:
Preexisting Conditions: chronic otitis media on Abx suppression
Allergies:
Diagnostic Lab Data: exam- no source of infection, urine - neg.
CDC 'Split Type':

Write-up: Temp 105 F, slow to come down with Tylenol & baths. Immunization given in a.m. Rxn in p.m. of same day. Had gotten DPT/OPV/MMR/HIB vaccine that day


Changed on 10/14/2018

VAERS ID: 25515 Before After
VAERS Form:1
Age:
Sex:Male
Location:Arizona
Vaccinated:1990-06-20
Onset:1990-06-20
Submitted:0000-00-00
Entered:1990-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Pyrexia

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: Suprax 100 mg qd
Current Illness:
Preexisting Conditions: chronic otitis media on Abx suppression
Allergies:
Diagnostic Lab Data: exam- no source of infection, urine - neg.
CDC 'Split Type':

Write-up: Temp 105 F, slow to come down with Tylenol & baths. Immunization given in a.m. Rxn in p.m. of same day. Had gotten DPT/OPV/MMR/HIB vaccine that day

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=25515&WAYBACKHISTORY=ON


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