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This is VAERS ID 25971

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 25971
VAERS Form:
Age:5.5
Sex:Female
Location:New Jersey
Vaccinated:1987-01-24
Onset:1987-01-24
Submitted:0000-00-00
Entered:1990-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE - / - - / IM

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

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: Referral to Audiologist for Brainstem Response Audiometry.
CDC 'Split Type':

Write-up: Pt vaccinated with DTP developed high fevers resulting in progressive hearing impairment. Had frequent assoc rx w/local induration & swelling of injection site. elevated temp noted w/progressive deterioration of hearing abilities.


Changed on 12/8/2009

VAERS ID: 25971 Before After
VAERS Form:
Age:5.5
Sex:Female
Location:New Jersey
Vaccinated:1987-01-24
Onset:1987-01-24
Submitted:0000-00-00
Entered:1990-09-20 1990-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL DTP (TRI-IMMUNOL) / LEDERLE LEDERLE LABORATORIES - / - - / IM

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

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: Referral to Audiologist for Brainstem Response Audiometry.
CDC 'Split Type':

Write-up: Pt vaccinated with DTP developed high fevers resulting in progressive hearing impairment. Had frequent assoc rx w/local induration & swelling of injection site. elevated temp noted w/progressive deterioration of hearing abilities.


Changed on 2/14/2017

VAERS ID: 25971 Before After
VAERS Form:
Age:5.5 5.0
Sex:Female
Location:New Jersey
Vaccinated:1987-01-24
Onset:1987-01-24
Submitted:0000-00-00
Entered:1990-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES - / - - / IM

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

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: Referral to Audiologist for Brainstem Response Audiometry.
CDC 'Split Type':

Write-up: Pt vaccinated with DTP developed high fevers resulting in progressive hearing impairment. Had frequent assoc rx w/local induration & swelling of injection site. elevated temp noted w/progressive deterioration of hearing abilities.


Changed on 5/14/2017

VAERS ID: 25971 Before After
VAERS Form:
Age:5.0
Sex:Female
Location:New Jersey
Vaccinated:1987-01-24
Onset:1987-01-24
Submitted:0000-00-00
Entered:1990-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES - / - - / IM

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

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: Referral to Audiologist for Brainstem Response Audiometry.
CDC 'Split Type':

Write-up: Pt vaccinated with DTP developed high fevers resulting in progressive hearing impairment. Had frequent assoc rx w/local induration & swelling of injection site. elevated temp noted w/progressive deterioration of hearing abilities.


Changed on 9/14/2017

VAERS ID: 25971 Before After
VAERS Form:(blank) 1
Age:5.0
Sex:Female
Location:New Jersey
Vaccinated:1987-01-24
Onset:1987-01-24
Submitted:0000-00-00
Entered:1990-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES - / - UNK - / IM

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

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: Referral to Audiologist for Brainstem Response Audiometry.
CDC 'Split Type':

Write-up: Pt vaccinated with DTP developed high fevers resulting in progressive hearing impairment. Had frequent assoc rx w/local induration & swelling of injection site. elevated temp noted w/progressive deterioration of hearing abilities.


Changed on 2/14/2018

VAERS ID: 25971 Before After
VAERS Form:1
Age:5.0
Sex:Female
Location:New Jersey
Vaccinated:1987-01-24
Onset:1987-01-24
Submitted:0000-00-00
Entered:1990-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES - / UNK - / IM

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

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: Referral to Audiologist for Brainstem Response Audiometry.
CDC 'Split Type':

Write-up: Pt vaccinated with DTP developed high fevers resulting in progressive hearing impairment. Had frequent assoc rx w/local induration & swelling of injection site. elevated temp noted w/progressive deterioration of hearing abilities.


Changed on 6/14/2018

VAERS ID: 25971 Before After
VAERS Form:1
Age:5.0
Sex:Female
Location:New Jersey
Vaccinated:1987-01-24
Onset:1987-01-24
Submitted:0000-00-00
Entered:1990-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES - / UNK - / IM

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

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: Referral to Audiologist for Brainstem Response Audiometry.
CDC 'Split Type':

Write-up: Pt vaccinated with DTP developed high fevers resulting in progressive hearing impairment. Had frequent assoc rx w/local induration & swelling of injection site. elevated temp noted w/progressive deterioration of hearing abilities.


Changed on 8/14/2018

VAERS ID: 25971 Before After
VAERS Form:1
Age:5.0
Sex:Female
Location:New Jersey
Vaccinated:1987-01-24
Onset:1987-01-24
Submitted:0000-00-00
Entered:1990-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES - / UNK - / IM

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

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: Referral to Audiologist for Brainstem Response Audiometry.
CDC 'Split Type':

Write-up: Pt vaccinated with DTP developed high fevers resulting in progressive hearing impairment. Had frequent assoc rx w/local induration & swelling of injection site. elevated temp noted w/progressive deterioration of hearing abilities.


Changed on 9/14/2018

VAERS ID: 25971 Before After
VAERS Form:1
Age:5.0
Sex:Female
Location:New Jersey
Vaccinated:1987-01-24
Onset:1987-01-24
Submitted:0000-00-00
Entered:1990-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES - / UNK - / IM

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

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: Referral to Audiologist for Brainstem Response Audiometry.
CDC 'Split Type':

Write-up: Pt vaccinated with DTP developed high fevers resulting in progressive hearing impairment. Had frequent assoc rx w/local induration & swelling of injection site. elevated temp noted w/progressive deterioration of hearing abilities.


Changed on 10/14/2018

VAERS ID: 25971 Before After
VAERS Form:1
Age:5.0
Sex:Female
Location:New Jersey
Vaccinated:1987-01-24
Onset:1987-01-24
Submitted:0000-00-00
Entered:1990-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES - / UNK - / IM

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

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: Referral to Audiologist for Brainstem Response Audiometry.
CDC 'Split Type':

Write-up: Pt vaccinated with DTP developed high fevers resulting in progressive hearing impairment. Had frequent assoc rx w/local induration & swelling of injection site. elevated temp noted w/progressive deterioration of hearing abilities.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=25971&WAYBACKHISTORY=ON


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