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History of Changes from the VAERS Wayback Machine |
VAERS ID: | 25769 |
VAERS Form: | |
Age: | 2.0 |
Sex: | Female |
Location: | Colorado |
Vaccinated: | 1987-09-04 |
Onset: | 0000-00-00 |
Submitted: | 0000-00-00 |
Entered: | 1990-08-28 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTP: TRI-IMMUNOL / LEDERLE | 175655 / - | - / - |
Administered by: Unknown Purchased by: Unknown
Symptoms: NEUROPATHY
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: Claimant under the NCVIA alleges that as a result of DTP on 4SEP87, infant suffered unspecified significant neurological deficiencies.
Vaccinated: | 1987-09-04 |
Onset: | 0000-00-00 |
Submitted: | 0000-00-00 |
Entered: | 1990-08-28 1990-08-23 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTP: TRI-IMMUNOL DTP (TRI-IMMUNOL) / LEDERLE LEDERLE LABORATORIES | 175655 / - | - / - |
Administered by: Unknown Purchased by: Unknown
Symptoms: Neuropathy, NEUROPATHY
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) 9000159.01
Write-up: Claimant under the NCVIA alleges that as a result of DTP on 4SEP87, infant suffered unspecified significant neurological deficiencies.
Vaccinated: | 1987-09-04 |
Onset: | 0000-00-00 |
Submitted: | 0000-00-00 |
Entered: | 1990-08-23 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES | 175655 / - | - / - |
Administered by: Unknown Purchased by: Unknown
Symptoms: Neuropathy
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': 9000159.01
Write-up: Claimant under the NCVIA alleges that as a result of DTP on 4SEP87, infant suffered unspecified significant neurological deficiencies.
Vaccinated: | 1987-09-04 |
Onset: | 0000-00-00 |
Submitted: | 0000-00-00 |
Entered: | 1990-08-23 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES | 175655 / - UNK | - / - |
Administered by: Unknown Purchased by: Unknown
Symptoms: Neuropathy
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': 9000159.01
Write-up: Claimant under the NCVIA alleges that as a result of DTP on 4SEP87, infant suffered unspecified significant neurological deficiencies.
Vaccinated: | 1987-09-04 |
Onset: | 0000-00-00 |
Submitted: | 0000-00-00 |
Entered: | 1990-08-23 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES | 175655 / UNK | - / - |
Administered by: Unknown Purchased by: Unknown
Symptoms: Neuropathy
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': 9000159.01
Write-up: Claimant under the NCVIA alleges that as a result of DTP on 4SEP87, infant suffered unspecified significant neurological deficiencies.
Vaccinated: | 1987-09-04 |
Onset: | 0000-00-00 |
Submitted: | 0000-00-00 |
Entered: | 1990-08-23 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES | 175655 / UNK | - / - |
Administered by: Unknown Purchased by: Unknown
Symptoms: Neuropathy
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': 9000159.01
Write-up: Claimant under the NCVIA alleges that as a result of DTP on 4SEP87, infant suffered unspecified significant neurological deficiencies.
Vaccinated: | 1987-09-04 |
Onset: | 0000-00-00 |
Submitted: | 0000-00-00 |
Entered: | 1990-08-23 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES | 175655 / UNK | - / - |
Administered by: Unknown Purchased by: Unknown
Symptoms: Neuropathy
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': 9000159.01
Write-up: Claimant under the NCVIA alleges that as a result of DTP on 4SEP87, infant suffered unspecified significant neurological deficiencies.
Vaccinated: | 1987-09-04 |
Onset: | 0000-00-00 |
Submitted: | 0000-00-00 |
Entered: | 1990-08-23 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES | 175655 / UNK | - / - |
Administered by: Unknown Purchased by: Unknown
Symptoms: Neuropathy
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': 9000159.01
Write-up: Claimant under the NCVIA alleges that as a result of DTP on 4SEP87, infant suffered unspecified significant neurological deficiencies.
Vaccinated: | 1987-09-04 |
Onset: | 0000-00-00 |
Submitted: | 0000-00-00 |
Entered: | 1990-08-23 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES | 175655 / UNK | - / - |
Administered by: Unknown Purchased by: Unknown
Symptoms: Neuropathy
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': 9000159.01
Write-up: Claimant under the NCVIA alleges that as a result of DTP on 4SEP87, infant suffered unspecified significant neurological deficiencies.
Vaccinated: | 1987-09-04 |
Onset: | 0000-00-00 |
Submitted: | 0000-00-00 |
Entered: | 1990-08-23 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES | 175655 / UNK | - / - |
Administered by: Unknown Purchased by: Unknown
Symptoms: Neuropathy
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': 9000159.01
Write-up: Claimant under the NCVIA alleges that as a result of DTP on 4SEP87, infant suffered unspecified significant neurological deficiencies.
Vaccinated: | 1987-09-04 |
Onset: | 0000-00-00 |
Submitted: | 0000-00-00 |
Entered: | 1990-08-23 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES | 175655 / UNK | - / - |
Administered by: Unknown Purchased by: Unknown
Symptoms: Neuropathy
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': 9000159.01
Write-up: Claimant under the NCVIA alleges that as a result of DTP on 4SEP87, infant suffered unspecified significant neurological deficiencies.
Link To This Search Result:
https://medalerts.org/vaersdb/findfield.php?IDNUMBER=25769&WAYBACKHISTORY=ON
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