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This is VAERS ID 25864

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 25864
VAERS Form:
Age:6.7
Sex:Male
Location:California
Vaccinated:1990-08-27
Onset:1990-08-27
Submitted:1990-08-31
Entered:1990-09-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP / CONNAUGHT LABS 0F11072 / 4 RA / IM
M: ATTENUVAX / MSD 1232S / 1 LA / IM
OPV: ORIMUNE / LEDERLE 265924 / - - / PO

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Pt vaccinated with DTP/OPV/Measles developed temp of 103 x 2 days and sore right arm for 3 days.


Changed on 12/8/2009

VAERS ID: 25864 Before After
VAERS Form:
Age:6.7
Sex:Male
Location:California
Vaccinated:1990-08-27
Onset:1990-08-27
Submitted:1990-08-31
Entered:1990-09-12 1990-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP DTP (NO BRAND NAME) / CONNAUGHT LABS CONNAUGHT LABORATORIES 0F11072 / 4 RA / IM
M: ATTENUVAX / MSD 1232S / 1 LA / IM
MEA: MEASLES (ATTENUVAX) / MERCK & CO. INC. 1232S / 1 LA / IM
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES 265924 / - - / PO

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Pt vaccinated with DTP/OPV/Measles developed temp of 103 x 2 days and sore right arm for 3 days.


Changed on 2/14/2017

VAERS ID: 25864 Before After
VAERS Form:
Age:6.7 6.0
Sex:Male
Location:California
Vaccinated:1990-08-27
Onset:1990-08-27
Submitted:1990-08-31
Entered:1990-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0F11072 / 4 RA / IM
MEA: MEASLES (ATTENUVAX) / MERCK & CO. INC. 1232S / 1 LA / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES 265924 / - - / PO

Administered by: Private      Purchased by: Private
Symptoms: Injection site reaction, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Pt vaccinated with DTP/OPV/Measles developed temp of 103 x 2 days and sore right arm for 3 days.


Changed on 5/14/2017

VAERS ID: 25864 Before After
VAERS Form:
Age:6.0
Sex:Male
Location:California
Vaccinated:1990-08-27
Onset:1990-08-27
Submitted:1990-08-31
Entered:1990-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0F11072 / 4 RA / IM
MEA: MEASLES (ATTENUVAX) / MERCK & CO. INC. 1232S / 1 LA / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 265924 / - - / PO

Administered by: Private      Purchased by: Private
Symptoms: Injection site reaction, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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':

Write-up: Pt vaccinated with DTP/OPV/Measles developed temp of 103 x 2 days and sore right arm for 3 days.


Changed on 9/14/2017

VAERS ID: 25864 Before After
VAERS Form:(blank) 1
Age:6.0
Sex:Male
Location:California
Vaccinated:1990-08-27
Onset:1990-08-27
Submitted:1990-08-31
Entered:1990-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0F11072 / 4 5 RA / IM
MEA: MEASLES (ATTENUVAX) / MERCK & CO. INC. 1232S / 1 2 LA / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 265924 / - UNK - MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Injection site reaction, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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':

Write-up: Pt vaccinated with DTP/OPV/Measles developed temp of 103 x 2 days and sore right arm for 3 days.


Changed on 2/14/2018

VAERS ID: 25864 Before After
VAERS Form:1
Age:6.0
Sex:Male
Location:California
Vaccinated:1990-08-27
Onset:1990-08-27
Submitted:1990-08-31
Entered:1990-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0F11072 / 5 RA / IM
MEA: MEASLES (ATTENUVAX) / MERCK & CO. INC. 1232S / 2 LA / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 265924 / UNK MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Injection site reaction, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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':

Write-up: Pt vaccinated with DTP/OPV/Measles developed temp of 103 x 2 days and sore right arm for 3 days.


Changed on 6/14/2018

VAERS ID: 25864 Before After
VAERS Form:1
Age:6.0
Sex:Male
Location:California
Vaccinated:1990-08-27
Onset:1990-08-27
Submitted:1990-08-31
Entered:1990-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0F11072 / 5 RA / IM
MEA: MEASLES (ATTENUVAX) / MERCK & CO. INC. 1232S / 2 LA / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 265924 / UNK MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Injection site reaction, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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':

Write-up: Pt vaccinated with DTP/OPV/Measles developed temp of 103 x 2 days and sore right arm for 3 days.


Changed on 8/14/2018

VAERS ID: 25864 Before After
VAERS Form:1
Age:6.0
Sex:Male
Location:California
Vaccinated:1990-08-27
Onset:1990-08-27
Submitted:1990-08-31
Entered:1990-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0F11072 / 5 RA / IM
MEA: MEASLES (ATTENUVAX) / MERCK & CO. INC. 1232S / 2 LA / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 265924 / UNK MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Injection site reaction, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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':

Write-up: Pt vaccinated with DTP/OPV/Measles developed temp of 103 x 2 days and sore right arm for 3 days.


Changed on 9/14/2018

VAERS ID: 25864 Before After
VAERS Form:1
Age:6.0
Sex:Male
Location:California
Vaccinated:1990-08-27
Onset:1990-08-27
Submitted:1990-08-31
Entered:1990-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0F11072 / 5 RA / IM
MEA: MEASLES (ATTENUVAX) / MERCK & CO. INC. 1232S / 2 LA / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 265924 / UNK MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Injection site reaction, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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':

Write-up: Pt vaccinated with DTP/OPV/Measles developed temp of 103 x 2 days and sore right arm for 3 days.


Changed on 10/14/2018

VAERS ID: 25864 Before After
VAERS Form:1
Age:6.0
Sex:Male
Location:California
Vaccinated:1990-08-27
Onset:1990-08-27
Submitted:1990-08-31
Entered:1990-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0F11072 / 5 RA / IM
MEA: MEASLES (ATTENUVAX) / MERCK & CO. INC. 1232S / 2 LA / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 265924 / UNK MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Injection site reaction, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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':

Write-up: Pt vaccinated with DTP/OPV/Measles developed temp of 103 x 2 days and sore right arm for 3 days.

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