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This is VAERS ID 26241

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 26241
VAERS Form:
Age:2.0
Sex:Female
Location:Wisconsin
Vaccinated:1989-06-20
Onset:1989-06-23
Submitted:0000-00-00
Entered:1990-10-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 232968 / 3 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: BRAIN SYND ACUTE, CONVULS, CEREBROVASC DIS, CSF ABNORM, ENCEPHALOPATHY

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-03-28
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? Yes, days: 60     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with DTP then death occurred 3/90. Cause of death listed as reaction to DTP vaccination.


Changed on 12/8/2009

VAERS ID: 26241 Before After
VAERS Form:
Age:2.0
Sex:Female
Location:Wisconsin
Vaccinated:1989-06-20
Onset:1989-06-23
Submitted:0000-00-00
Entered:1990-10-17 1990-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL DTP (TRI-IMMUNOL) / LEDERLE LEDERLE LABORATORIES 232968 / 3 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cerebrovascular disorder, Convulsion, Delirium, Encephalopathy, Hepatic necrosis, Neuropathy, Pneumonia, CSF test abnormal, BRAIN SYND ACUTE, CONVULS, CEREBROVASC DIS, CSF ABNORM, ENCEPHALOPATHY

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-03-28
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? Yes, days: 60     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) 9001578.01

Write-up: Pt vaccinated with DTP then death occurred 3/90. Cause of death listed as reaction to DTP vaccination.


Changed on 5/14/2017

VAERS ID: 26241 Before After
VAERS Form:
Age:2.0
Sex:Female
Location:Wisconsin
Vaccinated:1989-06-20
Onset:1989-06-23
Submitted:0000-00-00
Entered:1990-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 232968 / 3 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cerebrovascular disorder, Convulsion, Delirium, Encephalopathy, Hepatic necrosis, Neuropathy, Pneumonia, CSF test abnormal

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-03-28
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? Yes, days: 60     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 9001578.01

Write-up: Pt vaccinated with DTP then death occurred 3/90. Cause of death listed as reaction to DTP vaccination.


Changed on 9/14/2017

VAERS ID: 26241 Before After
VAERS Form:(blank) 1
Age:2.0
Sex:Female
Location:Wisconsin
Vaccinated:1989-06-20
Onset:1989-06-23
Submitted:0000-00-00
Entered:1990-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 232968 / 3 4 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cerebrovascular disorder, Convulsion, Delirium, Encephalopathy, Hepatic necrosis, Neuropathy, Pneumonia, CSF test abnormal

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-03-28
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? Yes, days: 60     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 9001578.01

Write-up: Pt vaccinated with DTP then death occurred 3/90. Cause of death listed as reaction to DTP vaccination.


Changed on 2/14/2018

VAERS ID: 26241 Before After
VAERS Form:1
Age:2.0
Sex:Female
Location:Wisconsin
Vaccinated:1989-06-20
Onset:1989-06-23
Submitted:0000-00-00
Entered:1990-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 232968 / 4 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cerebrovascular disorder, Convulsion, Delirium, Encephalopathy, Hepatic necrosis, Neuropathy, Pneumonia, CSF test abnormal

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-03-28
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? Yes, days: 60     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 9001578.01

Write-up: Pt vaccinated with DTP then death occurred 3/90. Cause of death listed as reaction to DTP vaccination.


Changed on 6/14/2018

VAERS ID: 26241 Before After
VAERS Form:1
Age:2.0
Sex:Female
Location:Wisconsin
Vaccinated:1989-06-20
Onset:1989-06-23
Submitted:0000-00-00
Entered:1990-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 232968 / 4 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cerebrovascular disorder, Convulsion, Delirium, Encephalopathy, Hepatic necrosis, Neuropathy, Pneumonia, CSF test abnormal

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-03-28
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? Yes, days: 60     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 9001578.01

Write-up: Pt vaccinated with DTP then death occurred 3/90. Cause of death listed as reaction to DTP vaccination.


Changed on 8/14/2018

VAERS ID: 26241 Before After
VAERS Form:1
Age:2.0
Sex:Female
Location:Wisconsin
Vaccinated:1989-06-20
Onset:1989-06-23
Submitted:0000-00-00
Entered:1990-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 232968 / 4 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cerebrovascular disorder, Convulsion, Delirium, Encephalopathy, Hepatic necrosis, Neuropathy, Pneumonia, CSF test abnormal

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-03-28
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? Yes, days: 60     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 9001578.01

Write-up: Pt vaccinated with DTP then death occurred 3/90. Cause of death listed as reaction to DTP vaccination.


Changed on 9/14/2018

VAERS ID: 26241 Before After
VAERS Form:1
Age:2.0
Sex:Female
Location:Wisconsin
Vaccinated:1989-06-20
Onset:1989-06-23
Submitted:0000-00-00
Entered:1990-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 232968 / 4 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cerebrovascular disorder, Convulsion, Delirium, Encephalopathy, Hepatic necrosis, Neuropathy, Pneumonia, CSF test abnormal

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-03-28
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? Yes, days: 60     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 9001578.01

Write-up: Pt vaccinated with DTP then death occurred 3/90. Cause of death listed as reaction to DTP vaccination.


Changed on 10/14/2018

VAERS ID: 26241 Before After
VAERS Form:1
Age:2.0
Sex:Female
Location:Wisconsin
Vaccinated:1989-06-20
Onset:1989-06-23
Submitted:0000-00-00
Entered:1990-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 232968 / 4 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cerebrovascular disorder, Convulsion, Delirium, Encephalopathy, Hepatic necrosis, Neuropathy, Pneumonia, CSF test abnormal

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-03-28
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? Yes, days: 60     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 9001578.01

Write-up: Pt vaccinated with DTP then death occurred 3/90. Cause of death listed as reaction to DTP vaccination.

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