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This is VAERS ID 25696

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 25696
VAERS Form:
Age:1.8
Sex:Female
Location:Illinois
Vaccinated:1990-05-14
Onset:1990-05-15
Submitted:0000-00-00
Entered:1990-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP / CONNAUGHT LABS OB11061 / - L / IM
MMR: MMR II / MSD 0890S / - L / IM
OPV: ORIMUNE / LEDERLE - / - - / PO

Administered by: Private      Purchased by: Unknown
Symptoms: INJECT SITE REACT, FEVER, PAIN INJECT SITE

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: Ceclor
Current Illness: Ear infection took Ceclor 5/7 -5/14
Preexisting Conditions: Infectious Mono in January 1990
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/MMR/OPV and developed a fever of 104.2; Temp decreased with tylenol and ice pack; Pain and swelling of leg site


Changed on 12/8/2009

VAERS ID: 25696 Before After
VAERS Form:
Age:1.8
Sex:Female
Location:Illinois
Vaccinated:1990-05-14
Onset:1990-05-15
Submitted:0000-00-00
Entered:1990-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP DTP (NO BRAND NAME) / CONNAUGHT LABS CONNAUGHT LABORATORIES OB11061 / - L / IM
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 0890S / - L / IM
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES - / - - / PO

Administered by: Private      Purchased by: Unknown
Symptoms: Injection site pain, Injection site reaction, Pyrexia, INJECT SITE REACT, FEVER, PAIN INJECT SITE

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: Ceclor
Current Illness: Ear infection took Ceclor 5/7 -5/14
Preexisting Conditions: Infectious Mono in January 1990
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/MMR/OPV and developed a fever of 104.2; Temp decreased with tylenol and ice pack; Pain and swelling of leg site


Changed on 5/14/2017

VAERS ID: 25696 Before After
VAERS Form:
Age:1.8
Sex:Female
Location:Illinois
Vaccinated:1990-05-14
Onset:1990-05-15
Submitted:0000-00-00
Entered:1990-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES OB11061 / - L - / IM IM L
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0890S / - L - / IM IM L
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH - / - - / PO

Administered by: Private      Purchased by: Unknown
Symptoms: Injection site pain, Injection site reaction, 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: Ceclor
Current Illness: Ear infection took Ceclor 5/7 -5/14
Preexisting Conditions: Infectious Mono in January 1990
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/MMR/OPV and developed a fever of 104.2; Temp decreased with tylenol and ice pack; Pain and swelling of leg site


Changed on 9/14/2017

VAERS ID: 25696 Before After
VAERS Form:(blank) 1
Age:1.8
Sex:Female
Location:Illinois
Vaccinated:1990-05-14
Onset:1990-05-15
Submitted:0000-00-00
Entered:1990-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES OB11061 / - UNK - / IM L
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0890S / - UNK - / IM L
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH - / - UNK - MO / PO

Administered by: Private      Purchased by: Unknown
Symptoms: Injection site pain, Injection site reaction, 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: Ceclor
Current Illness: Ear infection took Ceclor 5/7 -5/14
Preexisting Conditions: Infectious Mono in January 1990
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/MMR/OPV and developed a fever of 104.2; Temp decreased with tylenol and ice pack; Pain and swelling of leg site


Changed on 2/14/2018

VAERS ID: 25696 Before After
VAERS Form:1
Age:1.8
Sex:Female
Location:Illinois
Vaccinated:1990-05-14
Onset:1990-05-15
Submitted:0000-00-00
Entered:1990-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES OB11061 / UNK - / IM L
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0890S / UNK - / IM L
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH - / UNK MO / PO

Administered by: Private      Purchased by: Unknown
Symptoms: Injection site pain, Injection site reaction, 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: Ceclor
Current Illness: Ear infection took Ceclor 5/7 -5/14
Preexisting Conditions: Infectious Mono in January 1990
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/MMR/OPV and developed a fever of 104.2; Temp decreased with tylenol and ice pack; Pain and swelling of leg site


Changed on 6/14/2018

VAERS ID: 25696 Before After
VAERS Form:1
Age:1.8
Sex:Female
Location:Illinois
Vaccinated:1990-05-14
Onset:1990-05-15
Submitted:0000-00-00
Entered:1990-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES OB11061 / UNK - / IM L
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0890S / UNK - / IM L
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH - / UNK MO / PO

Administered by: Private      Purchased by: Unknown
Symptoms: Injection site pain, Injection site reaction, 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: Ceclor
Current Illness: Ear infection took Ceclor 5/7 -5/14
Preexisting Conditions: Infectious Mono in January 1990
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/MMR/OPV and developed a fever of 104.2; Temp decreased with tylenol and ice pack; Pain and swelling of leg site


Changed on 8/14/2018

VAERS ID: 25696 Before After
VAERS Form:1
Age:1.8
Sex:Female
Location:Illinois
Vaccinated:1990-05-14
Onset:1990-05-15
Submitted:0000-00-00
Entered:1990-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES OB11061 / UNK - / IM L
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0890S / UNK - / IM L
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH - / UNK MO / PO

Administered by: Private      Purchased by: Unknown
Symptoms: Injection site pain, Injection site reaction, 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: Ceclor
Current Illness: Ear infection took Ceclor 5/7 -5/14
Preexisting Conditions: Infectious Mono in January 1990
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/MMR/OPV and developed a fever of 104.2; Temp decreased with tylenol and ice pack; Pain and swelling of leg site


Changed on 9/14/2018

VAERS ID: 25696 Before After
VAERS Form:1
Age:1.8
Sex:Female
Location:Illinois
Vaccinated:1990-05-14
Onset:1990-05-15
Submitted:0000-00-00
Entered:1990-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES OB11061 / UNK - / IM L
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0890S / UNK - / IM L
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH - / UNK MO / PO

Administered by: Private      Purchased by: Unknown
Symptoms: Injection site pain, Injection site reaction, 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: Ceclor
Current Illness: Ear infection took Ceclor 5/7 -5/14
Preexisting Conditions: Infectious Mono in January 1990
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/MMR/OPV and developed a fever of 104.2; Temp decreased with tylenol and ice pack; Pain and swelling of leg site


Changed on 10/14/2018

VAERS ID: 25696 Before After
VAERS Form:1
Age:1.8
Sex:Female
Location:Illinois
Vaccinated:1990-05-14
Onset:1990-05-15
Submitted:0000-00-00
Entered:1990-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES OB11061 / UNK - / IM L
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0890S / UNK - / IM L
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH - / UNK MO / PO

Administered by: Private      Purchased by: Unknown
Symptoms: Injection site pain, Injection site reaction, 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: Ceclor
Current Illness: Ear infection took Ceclor 5/7 -5/14
Preexisting Conditions: Infectious Mono in January 1990
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/MMR/OPV and developed a fever of 104.2; Temp decreased with tylenol and ice pack; Pain and swelling of leg site

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