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This is VAERS ID 25817

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 25817
VAERS Form:
Age:2.6
Sex:Female
Location:Maryland
Vaccinated:1990-06-22
Onset:1990-06-30
Submitted:0000-00-00
Entered:1990-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 265938 / 3 - / -
M: UNK. MEASLES VIRUS LIVE / UNCLASSIFIED - / - - / -
OPV: ORIMUNE / LEDERLE - / - - / PO

Administered by: Private      Purchased by: Unknown
Symptoms: CONVULS, FEVER, RASH, ASTHENIA

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: No hx of seizures in siblings/parents. 1 cousin had convulsions /w high fever.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Approx. 8 days /p DTP/OPV/MMR immun., child experienced a fever 101T, rash on face & chest, seizure (1 episode) & fatigue for 24 hrs.


Changed on 12/8/2009

VAERS ID: 25817 Before After
VAERS Form:
Age:2.6
Sex:Female
Location:Maryland
Vaccinated:1990-06-22
Onset:1990-06-30
Submitted:0000-00-00
Entered:1990-08-30 1990-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL DTP (TRI-IMMUNOL) / LEDERLE LEDERLE LABORATORIES 265938 / 3 - / -
M: UNK. MEASLES VIRUS LIVE / UNCLASSIFIED - / - - / -
MEA: MEASLES (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES - / - - / PO

Administered by: Private      Purchased by: Unknown
Symptoms: Asthenia, Convulsion, Pyrexia, Rash, CONVULS, FEVER, RASH, ASTHENIA

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: No hx of seizures in siblings/parents. 1 cousin had convulsions /w high fever.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) 9001348.01

Write-up: Approx. 8 days /p DTP/OPV/MMR immun., child experienced a fever 101T, rash on face & chest, seizure (1 episode) & fatigue for 24 hrs.


Changed on 2/14/2017

VAERS ID: 25817 Before After
VAERS Form:
Age:2.6 2.0
Sex:Female
Location:Maryland
Vaccinated:1990-06-22
Onset:1990-06-30
Submitted:0000-00-00
Entered:1990-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 265938 / 3 - / -
MEA: MEASLES (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES - / - - / PO

Administered by: Private      Purchased by: Unknown
Symptoms: Asthenia, Convulsion, Pyrexia, Rash

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: No hx of seizures in siblings/parents. 1 cousin had convulsions /w high fever.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 9001348.01

Write-up: Approx. 8 days /p DTP/OPV/MMR immun., child experienced a fever 101T, rash on face & chest, seizure (1 episode) & fatigue for 24 hrs.


Changed on 5/14/2017

VAERS ID: 25817 Before After
VAERS Form:
Age:2.0
Sex:Female
Location:Maryland
Vaccinated:1990-06-22
Onset:1990-06-30
Submitted:0000-00-00
Entered:1990-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 265938 / 3 - / -
MEA: MEASLES (NO BRAND NAME) / UNKNOWN MANUFACTURER MERCK & CO. INC. - / - - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH - / - - / PO

Administered by: Private      Purchased by: Unknown
Symptoms: Asthenia, Convulsion, Pyrexia, Rash

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: No hx of seizures in siblings/parents. 1 cousin had convulsions /w high fever.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 9001348.01

Write-up: Approx. 8 days /p DTP/OPV/MMR immun., child experienced a fever 101T, rash on face & chest, seizure (1 episode) & fatigue for 24 hrs.


Changed on 9/14/2017

VAERS ID: 25817 Before After
VAERS Form:(blank) 1
Age:2.0
Sex:Female
Location:Maryland
Vaccinated:1990-06-22
Onset:1990-06-30
Submitted:0000-00-00
Entered:1990-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 265938 / 3 4 - / -
MEA: MEASLES (NO BRAND NAME) / MERCK & CO. INC. - / - UNK - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH - / - UNK - MO / PO

Administered by: Private      Purchased by: Unknown
Symptoms: Asthenia, Convulsion, Pyrexia, Rash

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: No hx of seizures in siblings/parents. 1 cousin had convulsions /w high fever.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 9001348.01

Write-up: Approx. 8 days /p DTP/OPV/MMR immun., child experienced a fever 101T, rash on face & chest, seizure (1 episode) & fatigue for 24 hrs.


Changed on 2/14/2018

VAERS ID: 25817 Before After
VAERS Form:1
Age:2.0
Sex:Female
Location:Maryland
Vaccinated:1990-06-22
Onset:1990-06-30
Submitted:0000-00-00
Entered:1990-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 265938 / 4 - / -
MEA: MEASLES (NO BRAND NAME) / MERCK & CO. INC. - / UNK - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH - / UNK MO / PO

Administered by: Private      Purchased by: Unknown
Symptoms: Asthenia, Convulsion, Pyrexia, Rash

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: No hx of seizures in siblings/parents. 1 cousin had convulsions /w high fever.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 9001348.01

Write-up: Approx. 8 days /p DTP/OPV/MMR immun., child experienced a fever 101T, rash on face & chest, seizure (1 episode) & fatigue for 24 hrs.


Changed on 6/14/2018

VAERS ID: 25817 Before After
VAERS Form:1
Age:2.0
Sex:Female
Location:Maryland
Vaccinated:1990-06-22
Onset:1990-06-30
Submitted:0000-00-00
Entered:1990-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 265938 / 4 - / -
MEA: MEASLES (NO BRAND NAME) / MERCK & CO. INC. - / UNK - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH - / UNK MO / PO

Administered by: Private      Purchased by: Unknown
Symptoms: Asthenia, Convulsion, Pyrexia, Rash

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: No hx of seizures in siblings/parents. 1 cousin had convulsions /w high fever.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 9001348.01

Write-up: Approx. 8 days /p DTP/OPV/MMR immun., child experienced a fever 101T, rash on face & chest, seizure (1 episode) & fatigue for 24 hrs.


Changed on 8/14/2018

VAERS ID: 25817 Before After
VAERS Form:1
Age:2.0
Sex:Female
Location:Maryland
Vaccinated:1990-06-22
Onset:1990-06-30
Submitted:0000-00-00
Entered:1990-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 265938 / 4 - / -
MEA: MEASLES (NO BRAND NAME) / MERCK & CO. INC. - / UNK - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH - / UNK MO / PO

Administered by: Private      Purchased by: Unknown
Symptoms: Asthenia, Convulsion, Pyrexia, Rash

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: No hx of seizures in siblings/parents. 1 cousin had convulsions /w high fever.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 9001348.01

Write-up: Approx. 8 days /p DTP/OPV/MMR immun., child experienced a fever 101T, rash on face & chest, seizure (1 episode) & fatigue for 24 hrs.


Changed on 9/14/2018

VAERS ID: 25817 Before After
VAERS Form:1
Age:2.0
Sex:Female
Location:Maryland
Vaccinated:1990-06-22
Onset:1990-06-30
Submitted:0000-00-00
Entered:1990-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 265938 / 4 - / -
MEA: MEASLES (NO BRAND NAME) / MERCK & CO. INC. - / UNK - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH - / UNK MO / PO

Administered by: Private      Purchased by: Unknown
Symptoms: Asthenia, Convulsion, Pyrexia, Rash

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: No hx of seizures in siblings/parents. 1 cousin had convulsions /w high fever.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 9001348.01

Write-up: Approx. 8 days /p DTP/OPV/MMR immun., child experienced a fever 101T, rash on face & chest, seizure (1 episode) & fatigue for 24 hrs.


Changed on 10/14/2018

VAERS ID: 25817 Before After
VAERS Form:1
Age:2.0
Sex:Female
Location:Maryland
Vaccinated:1990-06-22
Onset:1990-06-30
Submitted:0000-00-00
Entered:1990-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 265938 / 4 - / -
MEA: MEASLES (NO BRAND NAME) / MERCK & CO. INC. - / UNK - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH - / UNK MO / PO

Administered by: Private      Purchased by: Unknown
Symptoms: Asthenia, Convulsion, Pyrexia, Rash

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: No hx of seizures in siblings/parents. 1 cousin had convulsions /w high fever.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 9001348.01

Write-up: Approx. 8 days /p DTP/OPV/MMR immun., child experienced a fever 101T, rash on face & chest, seizure (1 episode) & fatigue for 24 hrs.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=25817&WAYBACKHISTORY=ON


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