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This is VAERS ID 25557

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 25557
VAERS Form:
Age:1.3
Sex:Female
Location:Indiana
Vaccinated:1990-07-09
Onset:1990-07-11
Submitted:0000-00-00
Entered:1990-07-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 279945 / - - / -
MMR: MMR II / MSD 2366R / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: CONVULS, FEVER, VOMIT, APNEA, LAB TEST ABNORM

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: WBC 13.0, RBC 4.37, HgB 10.3, Hct 31.4, MCV 72, MCH 23.6, MCHC 32.8, Platelets 450, Seg 82, lymph 16, stab 2
CDC 'Split Type':

Write-up: Onset w/ fever, napped, woke w/ jerking -all extremities - & seemed to stop breathing, vomited X1. No sxs 7-10-90. Given APAP q4h on 7-11-90.


Changed on 12/8/2009

VAERS ID: 25557 Before After
VAERS Form:
Age:1.3
Sex:Female
Location:Indiana
Vaccinated:1990-07-09
Onset:1990-07-11
Submitted:0000-00-00
Entered:1990-07-24 1990-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL DTP (TRI-IMMUNOL) / LEDERLE LEDERLE LABORATORIES 279945 / - - / -
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 2366R / - - / -

Administered by: Private      Purchased by: Unknown Private
Symptoms: Apnoea, Convulsion, Laboratory test abnormal, Pyrexia, Vomiting, CONVULS, FEVER, VOMIT, APNEA, LAB TEST ABNORM

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: WBC 13.0, RBC 4.37, HgB 10.3, Hct 31.4, MCV 72, MCH 23.6, MCHC 32.8, Platelets 450, Seg 82, lymph 16, stab 2
CDC 'Split Type':

Write-up: Onset w/ fever, napped, woke w/ jerking -all extremities - & seemed to stop breathing, vomited X1. No sxs 7-10-90. Given APAP q4h on 7-11-90.


Changed on 5/14/2017

VAERS ID: 25557 Before After
VAERS Form:
Age:1.3
Sex:Female
Location:Indiana
Vaccinated:1990-07-09
Onset:1990-07-11
Submitted:0000-00-00
Entered:1990-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 279945 / - - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 2366R / - - / -

Administered by: Private      Purchased by: Private
Symptoms: Apnoea, Convulsion, Laboratory test abnormal, Pyrexia, Vomiting

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: WBC 13.0, RBC 4.37, HgB 10.3, Hct 31.4, MCV 72, MCH 23.6, MCHC 32.8, Platelets 450, Seg 82, lymph 16, stab 2
CDC 'Split Type':

Write-up: Onset w/ fever, napped, woke w/ jerking -all extremities - & seemed to stop breathing, vomited X1. No sxs 7-10-90. Given APAP q4h on 7-11-90.


Changed on 9/14/2017

VAERS ID: 25557 Before After
VAERS Form:(blank) 1
Age:1.3
Sex:Female
Location:Indiana
Vaccinated:1990-07-09
Onset:1990-07-11
Submitted:0000-00-00
Entered:1990-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 279945 / - UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 2366R / - UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Apnoea, Convulsion, Laboratory test abnormal, Pyrexia, Vomiting

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: WBC 13.0, RBC 4.37, HgB 10.3, Hct 31.4, MCV 72, MCH 23.6, MCHC 32.8, Platelets 450, Seg 82, lymph 16, stab 2
CDC 'Split Type':

Write-up: Onset w/ fever, napped, woke w/ jerking -all extremities - & seemed to stop breathing, vomited X1. No sxs 7-10-90. Given APAP q4h on 7-11-90.


Changed on 2/14/2018

VAERS ID: 25557 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Indiana
Vaccinated:1990-07-09
Onset:1990-07-11
Submitted:0000-00-00
Entered:1990-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 279945 / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 2366R / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Apnoea, Convulsion, Laboratory test abnormal, Pyrexia, Vomiting

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: WBC 13.0, RBC 4.37, HgB 10.3, Hct 31.4, MCV 72, MCH 23.6, MCHC 32.8, Platelets 450, Seg 82, lymph 16, stab 2
CDC 'Split Type':

Write-up: Onset w/ fever, napped, woke w/ jerking -all extremities - & seemed to stop breathing, vomited X1. No sxs 7-10-90. Given APAP q4h on 7-11-90.


Changed on 6/14/2018

VAERS ID: 25557 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Indiana
Vaccinated:1990-07-09
Onset:1990-07-11
Submitted:0000-00-00
Entered:1990-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 279945 / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 2366R / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Apnoea, Convulsion, Laboratory test abnormal, Pyrexia, Vomiting

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: WBC 13.0, RBC 4.37, HgB 10.3, Hct 31.4, MCV 72, MCH 23.6, MCHC 32.8, Platelets 450, Seg 82, lymph 16, stab 2
CDC 'Split Type':

Write-up: Onset w/ fever, napped, woke w/ jerking -all extremities - & seemed to stop breathing, vomited X1. No sxs 7-10-90. Given APAP q4h on 7-11-90.


Changed on 8/14/2018

VAERS ID: 25557 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Indiana
Vaccinated:1990-07-09
Onset:1990-07-11
Submitted:0000-00-00
Entered:1990-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 279945 / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 2366R / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Apnoea, Convulsion, Laboratory test abnormal, Pyrexia, Vomiting

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: WBC 13.0, RBC 4.37, HgB 10.3, Hct 31.4, MCV 72, MCH 23.6, MCHC 32.8, Platelets 450, Seg 82, lymph 16, stab 2
CDC 'Split Type':

Write-up: Onset w/ fever, napped, woke w/ jerking -all extremities - & seemed to stop breathing, vomited X1. No sxs 7-10-90. Given APAP q4h on 7-11-90.


Changed on 9/14/2018

VAERS ID: 25557 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Indiana
Vaccinated:1990-07-09
Onset:1990-07-11
Submitted:0000-00-00
Entered:1990-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 279945 / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 2366R / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Apnoea, Convulsion, Laboratory test abnormal, Pyrexia, Vomiting

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: WBC 13.0, RBC 4.37, HgB 10.3, Hct 31.4, MCV 72, MCH 23.6, MCHC 32.8, Platelets 450, Seg 82, lymph 16, stab 2
CDC 'Split Type':

Write-up: Onset w/ fever, napped, woke w/ jerking -all extremities - & seemed to stop breathing, vomited X1. No sxs 7-10-90. Given APAP q4h on 7-11-90.


Changed on 10/14/2018

VAERS ID: 25557 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Indiana
Vaccinated:1990-07-09
Onset:1990-07-11
Submitted:0000-00-00
Entered:1990-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 279945 / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 2366R / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Apnoea, Convulsion, Laboratory test abnormal, Pyrexia, Vomiting

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: WBC 13.0, RBC 4.37, HgB 10.3, Hct 31.4, MCV 72, MCH 23.6, MCHC 32.8, Platelets 450, Seg 82, lymph 16, stab 2
CDC 'Split Type':

Write-up: Onset w/ fever, napped, woke w/ jerking -all extremities - & seemed to stop breathing, vomited X1. No sxs 7-10-90. Given APAP q4h on 7-11-90.

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