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History of Changes from the VAERS Wayback Machine |
VAERS ID: | 25534 |
VAERS Form: | |
Age: | 4.0 |
Sex: | Female |
Location: | New York |
Vaccinated: | 1987-12-09 |
Onset: | 1990-06-25 |
Submitted: | 0000-00-00 |
Entered: | 1990-07-19 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HBPV: HIBIMUNE / LEDERLE | 181666 / - | - / - |
Administered by: Private Purchased by: Unknown
Symptoms: INFECT, NO DRUG EFFECT
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:1990-06-25
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:
CDC 'Split Type':
Write-up: 4 1/2 yr old child 25Jun90/w positive blood culture for h. Influenzae type B. Child received immunization on 9Dec87
Vaccinated: | 1987-12-09 |
Onset: | 1990-06-25 |
Submitted: | 0000-00-00 |
Entered: | 1990-07-19 1990-07-16 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HBPV: HIBIMUNE HIB POLYSACCHARIDE (HIBIMUNE) / LEDERLE LEDERLE LABORATORIES | 181666 / - | - / - |
Administered by: Private Purchased by: Unknown
Symptoms: Drug ineffective, Infection, INFECT, NO DRUG EFFECT
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:1990-06-25
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:
CDC 'Split Type': (blank) 9001160.01
Write-up: 4 1/2 yr old child 25Jun90/w positive blood culture for h. Influenzae type B. Child received immunization on 9Dec87
Vaccinated: | 1987-12-09 |
Onset: | 1990-06-25 |
Submitted: | 0000-00-00 |
Entered: | 1990-07-16 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HBPV: HIB POLYSACCHARIDE (HIBIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH | 181666 / - | - / - |
Administered by: Private Purchased by: Unknown
Symptoms: Drug ineffective, Infection
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:1990-06-25
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:
CDC 'Split Type': 9001160.01
Write-up: 4 1/2 yr old child 25Jun90/w positive blood culture for h. Influenzae type B. Child received immunization on 9Dec87
Vaccinated: | 1987-12-09 |
Onset: | 1990-06-25 |
Submitted: | 0000-00-00 |
Entered: | 1990-07-16 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HBPV: HIB POLYSACCHARIDE (HIBIMUNE) / PFIZER/WYETH | 181666 / - UNK | - / - |
Administered by: Private Purchased by: Unknown
Symptoms: Drug ineffective, Infection
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:1990-06-25
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:
CDC 'Split Type': 9001160.01
Write-up: 4 1/2 yr old child 25Jun90/w positive blood culture for h. Influenzae type B. Child received immunization on 9Dec87
Vaccinated: | 1987-12-09 |
Onset: | 1990-06-25 |
Submitted: | 0000-00-00 |
Entered: | 1990-07-16 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HBPV: HIB POLYSACCHARIDE (HIBIMUNE) / PFIZER/WYETH | 181666 / UNK | - / - |
Administered by: Private Purchased by: Unknown
Symptoms: Drug ineffective, Infection
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:1990-06-25
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:
CDC 'Split Type': 9001160.01
Write-up: 4 1/2 yr old child 25Jun90/w positive blood culture for h. Influenzae type B. Child received immunization on 9Dec87
Vaccinated: | 1987-12-09 |
Onset: | 1990-06-25 |
Submitted: | 0000-00-00 |
Entered: | 1990-07-16 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HBPV: HIB POLYSACCHARIDE (HIBIMUNE) / PFIZER/WYETH | 181666 / UNK | - / - |
Administered by: Private Purchased by: Unknown
Symptoms: Drug ineffective, Infection
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:1990-06-25
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:
CDC 'Split Type': 9001160.01
Write-up: 4 1/2 yr old child 25Jun90/w positive blood culture for h. Influenzae type B. Child received immunization on 9Dec87
Vaccinated: | 1987-12-09 |
Onset: | 1990-06-25 |
Submitted: | 0000-00-00 |
Entered: | 1990-07-16 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HBPV: HIB POLYSACCHARIDE (HIBIMUNE) / PFIZER/WYETH | 181666 / UNK | - / - |
Administered by: Private Purchased by: Unknown
Symptoms: Drug ineffective, Infection
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:1990-06-25
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:
CDC 'Split Type': 9001160.01
Write-up: 4 1/2 yr old child 25Jun90/w positive blood culture for h. Influenzae type B. Child received immunization on 9Dec87
Vaccinated: | 1987-12-09 |
Onset: | 1990-06-25 |
Submitted: | 0000-00-00 |
Entered: | 1990-07-16 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HBPV: HIB POLYSACCHARIDE (HIBIMUNE) / PFIZER/WYETH | 181666 / UNK | - / - |
Administered by: Private Purchased by: Unknown
Symptoms: Drug ineffective, Infection
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:1990-06-25
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:
CDC 'Split Type': 9001160.01
Write-up: 4 1/2 yr old child 25Jun90/w positive blood culture for h. Influenzae type B. Child received immunization on 9Dec87
Vaccinated: | 1987-12-09 |
Onset: | 1990-06-25 |
Submitted: | 0000-00-00 |
Entered: | 1990-07-16 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HBPV: HIB POLYSACCHARIDE (HIBIMUNE) / PFIZER/WYETH | 181666 / UNK | - / - |
Administered by: Private Purchased by: Unknown
Symptoms: Drug ineffective, Infection
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:1990-06-25
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:
CDC 'Split Type': 9001160.01
Write-up: 4 1/2 yr old child 25Jun90/w positive blood culture for h. Influenzae type B. Child received immunization on 9Dec87
Vaccinated: | 1987-12-09 |
Onset: | 1990-06-25 |
Submitted: | 0000-00-00 |
Entered: | 1990-07-16 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HBPV: HIB POLYSACCHARIDE (HIBIMUNE) / PFIZER/WYETH | 181666 / UNK | - / - |
Administered by: Private Purchased by: Unknown
Symptoms: Drug ineffective, Infection
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:1990-06-25
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:
CDC 'Split Type': 9001160.01
Write-up: 4 1/2 yr old child 25Jun90/w positive blood culture for h. Influenzae type B. Child received immunization on 9Dec87
Vaccinated: | 1987-12-09 |
Onset: | 1990-06-25 |
Submitted: | 0000-00-00 |
Entered: | 1990-07-16 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HBPV: HIB POLYSACCHARIDE (HIBIMUNE) / PFIZER/WYETH | 181666 / UNK | - / - |
Administered by: Private Purchased by: Unknown
Symptoms: Drug ineffective, Infection
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:1990-06-25
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:
CDC 'Split Type': 9001160.01
Write-up: 4 1/2 yr old child 25Jun90/w positive blood culture for h. Influenzae type B. Child received immunization on 9Dec87
Link To This Search Result:
https://medalerts.org/vaersdb/findfield.php?IDNUMBER=25534&WAYBACKHISTORY=ON
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