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This is VAERS ID 26592

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 26592
VAERS Form:
Age:1.5
Sex:Female
Location:Tennessee
Vaccinated:1990-10-03
Onset:1990-10-26
Submitted:0000-00-00
Entered:1990-11-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: PROHIBIT / CONNAUGHT LABS 0J11070 / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: SIDS

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: Estrace Cream
Current Illness:
Preexisting Conditions: Premature birth 2lbs 13 oz
Allergies:
Diagnostic Lab Data: Autopsy pending
CDC 'Split Type':

Write-up: Pt vaccinated with PROHIBIT DOA to Hosp.


Changed on 12/8/2009

VAERS ID: 26592 Before After
VAERS Form:
Age:1.5
Sex:Female
Location:Tennessee
Vaccinated:1990-10-03
Onset:1990-10-26
Submitted:0000-00-00
Entered:1990-11-13 1990-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: PROHIBIT HIB (PROHIBIT) / CONNAUGHT LABS CONNAUGHT LABORATORIES 0J11070 / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: SIDS, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: Estrace Cream
Current Illness:
Preexisting Conditions: Premature birth 2lbs 13 oz
Allergies:
Diagnostic Lab Data: Autopsy pending
CDC 'Split Type':

Write-up: Pt vaccinated with PROHIBIT DOA to Hosp.


Changed on 5/14/2017

VAERS ID: 26592 Before After
VAERS Form:
Age:1.5
Sex:Female
Location:Tennessee
Vaccinated:1990-10-03
Onset:1990-10-26
Submitted:0000-00-00
Entered:1990-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0J11070 / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: Estrace Cream
Current Illness:
Preexisting Conditions: Premature birth 2lbs 13 oz
Allergies:
Diagnostic Lab Data: Autopsy pending
CDC 'Split Type':

Write-up: Pt vaccinated with PROHIBIT DOA to Hosp.


Changed on 9/14/2017

VAERS ID: 26592 Before After
VAERS Form:(blank) 1
Age:1.5
Sex:Female
Location:Tennessee
Vaccinated:1990-10-03
Onset:1990-10-26
Submitted:0000-00-00
Entered:1990-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0J11070 / - UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: Estrace Cream
Current Illness:
Preexisting Conditions: Premature birth 2lbs 13 oz
Allergies:
Diagnostic Lab Data: Autopsy pending
CDC 'Split Type':

Write-up: Pt vaccinated with PROHIBIT DOA to Hosp.


Changed on 2/14/2018

VAERS ID: 26592 Before After
VAERS Form:1
Age:1.5
Sex:Female
Location:Tennessee
Vaccinated:1990-10-03
Onset:1990-10-26
Submitted:0000-00-00
Entered:1990-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0J11070 / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: Estrace Cream
Current Illness:
Preexisting Conditions: Premature birth 2lbs 13 oz
Allergies:
Diagnostic Lab Data: Autopsy pending
CDC 'Split Type':

Write-up: Pt vaccinated with PROHIBIT DOA to Hosp.


Changed on 6/14/2018

VAERS ID: 26592 Before After
VAERS Form:1
Age:1.5
Sex:Female
Location:Tennessee
Vaccinated:1990-10-03
Onset:1990-10-26
Submitted:0000-00-00
Entered:1990-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0J11070 / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: Estrace Cream
Current Illness:
Preexisting Conditions: Premature birth 2lbs 13 oz
Allergies:
Diagnostic Lab Data: Autopsy pending
CDC 'Split Type':

Write-up: Pt vaccinated with PROHIBIT DOA to Hosp.


Changed on 8/14/2018

VAERS ID: 26592 Before After
VAERS Form:1
Age:1.5
Sex:Female
Location:Tennessee
Vaccinated:1990-10-03
Onset:1990-10-26
Submitted:0000-00-00
Entered:1990-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0J11070 / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: Estrace Cream
Current Illness:
Preexisting Conditions: Premature birth 2lbs 13 oz
Allergies:
Diagnostic Lab Data: Autopsy pending
CDC 'Split Type':

Write-up: Pt vaccinated with PROHIBIT DOA to Hosp.


Changed on 9/14/2018

VAERS ID: 26592 Before After
VAERS Form:1
Age:1.5
Sex:Female
Location:Tennessee
Vaccinated:1990-10-03
Onset:1990-10-26
Submitted:0000-00-00
Entered:1990-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0J11070 / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: Estrace Cream
Current Illness:
Preexisting Conditions: Premature birth 2lbs 13 oz
Allergies:
Diagnostic Lab Data: Autopsy pending
CDC 'Split Type':

Write-up: Pt vaccinated with PROHIBIT DOA to Hosp.


Changed on 10/14/2018

VAERS ID: 26592 Before After
VAERS Form:1
Age:1.5
Sex:Female
Location:Tennessee
Vaccinated:1990-10-03
Onset:1990-10-26
Submitted:0000-00-00
Entered:1990-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0J11070 / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: Estrace Cream
Current Illness:
Preexisting Conditions: Premature birth 2lbs 13 oz
Allergies:
Diagnostic Lab Data: Autopsy pending
CDC 'Split Type':

Write-up: Pt vaccinated with PROHIBIT DOA to Hosp.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=26592&WAYBACKHISTORY=ON


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