This is VAERS ID 25542

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

Vaccin­ation / Manu­facturer	Lot / Dose	Site / Route
DTP: TRI-IMMUNOL / LEDERLE	- / -	- / -

Administered by: Private      Purchased by: Unknown
Symptoms: MENTAL RETARD, ANOMALY HEART

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:
CDC 'Split Type':

Write-up: immunized 1968, experienced developmental delay, dysmorphism, hypertelorism, thick tongue, asymptomatic pulmonary stenosis, possible Turner''s Noonan''s syndrome & heart murmur, child last seen by reporter 1971

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Changed on 12/30/2006

Vaccin­ation / Manu­facturer	Lot / Dose	Site / Route
DTP: TRI-IMMUNOL / LEDERLE	- / -	- / -

Administered by: Private      Purchased by: Unknown
Symptoms: MENTAL RETARD, ANOMALY HEART

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:
CDC 'Split Type':

Write-up: immunized 1968, experienced developmental delay, dysmorphism, hypertelorism, thick tongue, asymptomatic pulmonary stenosis, possible Turner''s Noonan''s Turner''''s Noonan''''s syndrome & heart murmur, child last seen by reporter 1971

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Changed on 12/8/2009

Vaccin­ation / Manu­facturer	Lot / Dose	Site / Route
DTP: TRI-IMMUNOL DTP (TRI-IMMUNOL) / LEDERLE LEDERLE LABORATORIES	- / -	- / -

Administered by: Private      Purchased by: Unknown
Symptoms: Heart disease congenital, Mental retardation severity unspecified, MENTAL RETARD, ANOMALY HEART

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:
CDC 'Split Type': (blank) 9001111.01

Write-up: immunized 1968, experienced developmental delay, dysmorphism, hypertelorism, thick tongue, asymptomatic pulmonary stenosis, possible Turner''''s Noonan''''s Turner''s Noonan''s syndrome & heart murmur, child last seen by reporter 1971

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Changed on 5/14/2017

Vaccin­ation / Manu­facturer	Lot / Dose	Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES	- / -	- / -

Administered by: Private      Purchased by: Unknown
Symptoms: Heart disease congenital, Mental retardation severity unspecified

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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 9001111.01

Write-up: immunized 1968, experienced developmental delay, dysmorphism, hypertelorism, thick tongue, asymptomatic pulmonary stenosis, possible Turner''s Noonan''s syndrome & heart murmur, child last seen by reporter 1971

---

Changed on 9/14/2017

Vaccin­ation / Manu­facturer	Lot / Dose	Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES	- / - UNK	- / -

Administered by: Private      Purchased by: Unknown
Symptoms: Heart disease congenital, Mental retardation severity unspecified

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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 9001111.01

Write-up: immunized 1968, experienced developmental delay, dysmorphism, hypertelorism, thick tongue, asymptomatic pulmonary stenosis, possible Turner''s Noonan''s syndrome & heart murmur, child last seen by reporter 1971

---

Changed on 2/14/2018

Vaccin­ation / Manu­facturer	Lot / Dose	Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES	- / UNK	- / -

Administered by: Private      Purchased by: Unknown
Symptoms: Heart disease congenital, Mental retardation severity unspecified

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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 9001111.01

Write-up: immunized 1968, experienced developmental delay, dysmorphism, hypertelorism, thick tongue, asymptomatic pulmonary stenosis, possible Turner''s Noonan''s syndrome & heart murmur, child last seen by reporter 1971

---

Changed on 6/14/2018

Vaccin­ation / Manu­facturer	Lot / Dose	Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES	- / UNK	- / -

Administered by: Private      Purchased by: Unknown
Symptoms: Heart disease congenital, Mental retardation severity unspecified

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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 9001111.01

Write-up: immunized 1968, experienced developmental delay, dysmorphism, hypertelorism, thick tongue, asymptomatic pulmonary stenosis, possible Turner''s Noonan''s syndrome & heart murmur, child last seen by reporter 1971

---

Changed on 8/14/2018

Vaccin­ation / Manu­facturer	Lot / Dose	Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES	- / UNK	- / -

Administered by: Private      Purchased by: Unknown
Symptoms: Heart disease congenital, Mental retardation severity unspecified

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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 9001111.01

Write-up: immunized 1968, experienced developmental delay, dysmorphism, hypertelorism, thick tongue, asymptomatic pulmonary stenosis, possible Turner''s Noonan''s syndrome & heart murmur, child last seen by reporter 1971

---

Changed on 9/14/2018

Vaccin­ation / Manu­facturer	Lot / Dose	Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES	- / UNK	- / -

Administered by: Private      Purchased by: Unknown
Symptoms: Heart disease congenital, Mental retardation severity unspecified

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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 9001111.01

Write-up: immunized 1968, experienced developmental delay, dysmorphism, hypertelorism, thick tongue, asymptomatic pulmonary stenosis, possible Turner''s Noonan''s syndrome & heart murmur, child last seen by reporter 1971

---

Changed on 10/14/2018

Vaccin­ation / Manu­facturer	Lot / Dose	Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES	- / UNK	- / -

Administered by: Private      Purchased by: Unknown
Symptoms: Heart disease congenital, Mental retardation severity unspecified

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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 9001111.01

Write-up: immunized 1968, experienced developmental delay, dysmorphism, hypertelorism, thick tongue, asymptomatic pulmonary stenosis, possible Turner''s Noonan''s syndrome & heart murmur, child last seen by reporter 1971

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