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This is VAERS ID 26913

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 26913
VAERS Form:
Age:2.1
Sex:Male
Location:Alabama
Vaccinated:1990-11-26
Onset:1990-11-26
Submitted:1990-11-28
Entered:1990-12-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 281947 / 2 RL / -
MMR: MMR II / MSD 1879S / 0 LA / -
OPV: ORIMUNE / LEDERLE 283938 / 2 - / PO

Administered by: Public      Purchased by: Unknown
Symptoms: FEVER, VOMIT, DIARRHEA

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: PPD vaccine by Connaught Lot# 231912
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/OPV/MMR began vomiting & diarrhea around 830PM. Temp to 104. Mom call ER & MD, but did not take child to either.


Changed on 12/8/2009

VAERS ID: 26913 Before After
VAERS Form:
Age:2.1
Sex:Male
Location:Alabama
Vaccinated:1990-11-26
Onset:1990-11-26
Submitted:1990-11-28
Entered:1990-12-11 1990-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL DTP (TRI-IMMUNOL) / LEDERLE LEDERLE LABORATORIES 281947 / 2 RL / -
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 1879S / 0 LA / -
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES 283938 / 2 - / PO

Administered by: Public      Purchased by: Unknown Other
Symptoms: Diarrhoea, Pyrexia, Vomiting, FEVER, VOMIT, DIARRHEA

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: PPD vaccine by Connaught Lot# 231912
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) AL900003

Write-up: Pt vaccinated with DTP/OPV/MMR began vomiting & diarrhea around 830PM. Temp to 104. Mom call ER & MD, but did not take child to either.


Changed on 2/14/2017

VAERS ID: 26913 Before After
VAERS Form:
Age:2.1 2.0
Sex:Male
Location:Alabama
Vaccinated:1990-11-26
Onset:1990-11-26
Submitted:1990-11-28
Entered:1990-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 281947 / 2 RL / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1879S / 0 LA / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES 283938 / 2 - / PO

Administered by: Public      Purchased by: Other
Symptoms: Diarrhoea, Pyrexia, Vomiting

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: PPD vaccine by Connaught Lot# 231912
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': AL900003

Write-up: Pt vaccinated with DTP/OPV/MMR began vomiting & diarrhea around 830PM. Temp to 104. Mom call ER & MD, but did not take child to either.


Changed on 5/14/2017

VAERS ID: 26913 Before After
VAERS Form:
Age:2.0
Sex:Male
Location:Alabama
Vaccinated:1990-11-26
Onset:1990-11-26
Submitted:1990-11-28
Entered:1990-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 281947 / 2 RL / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1879S / 0 LA / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 283938 / 2 - / PO

Administered by: Public      Purchased by: Other
Symptoms: Diarrhoea, Pyrexia, Vomiting

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: PPD vaccine by Connaught Lot# 231912
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': AL900003

Write-up: Pt vaccinated with DTP/OPV/MMR began vomiting & diarrhea around 830PM. Temp to 104. Mom call ER & MD, but did not take child to either.


Changed on 9/14/2017

VAERS ID: 26913 Before After
VAERS Form:(blank) 1
Age:2.0
Sex:Male
Location:Alabama
Vaccinated:1990-11-26
Onset:1990-11-26
Submitted:1990-11-28
Entered:1990-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 281947 / 2 3 RL / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1879S / 0 1 LA / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 283938 / 2 3 - MO / PO

Administered by: Public      Purchased by: Other
Symptoms: Diarrhoea, Pyrexia, Vomiting

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: PPD vaccine by Connaught Lot# 231912
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': AL900003

Write-up: Pt vaccinated with DTP/OPV/MMR began vomiting & diarrhea around 830PM. Temp to 104. Mom call ER & MD, but did not take child to either.


Changed on 2/14/2018

VAERS ID: 26913 Before After
VAERS Form:1
Age:2.0
Sex:Male
Location:Alabama
Vaccinated:1990-11-26
Onset:1990-11-26
Submitted:1990-11-28
Entered:1990-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 281947 / 3 RL / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1879S / 1 LA / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 283938 / 3 MO / PO

Administered by: Public      Purchased by: Other
Symptoms: Diarrhoea, Pyrexia, Vomiting

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: PPD vaccine by Connaught Lot# 231912
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': AL900003

Write-up: Pt vaccinated with DTP/OPV/MMR began vomiting & diarrhea around 830PM. Temp to 104. Mom call ER & MD, but did not take child to either.


Changed on 6/14/2018

VAERS ID: 26913 Before After
VAERS Form:1
Age:2.0
Sex:Male
Location:Alabama
Vaccinated:1990-11-26
Onset:1990-11-26
Submitted:1990-11-28
Entered:1990-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 281947 / 3 RL / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1879S / 1 LA / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 283938 / 3 MO / PO

Administered by: Public      Purchased by: Other
Symptoms: Diarrhoea, Pyrexia, Vomiting

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: PPD vaccine by Connaught Lot# 231912
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': AL900003

Write-up: Pt vaccinated with DTP/OPV/MMR began vomiting & diarrhea around 830PM. Temp to 104. Mom call ER & MD, but did not take child to either.


Changed on 8/14/2018

VAERS ID: 26913 Before After
VAERS Form:1
Age:2.0
Sex:Male
Location:Alabama
Vaccinated:1990-11-26
Onset:1990-11-26
Submitted:1990-11-28
Entered:1990-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 281947 / 3 RL / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1879S / 1 LA / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 283938 / 3 MO / PO

Administered by: Public      Purchased by: Other
Symptoms: Diarrhoea, Pyrexia, Vomiting

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: PPD vaccine by Connaught Lot# 231912
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': AL900003

Write-up: Pt vaccinated with DTP/OPV/MMR began vomiting & diarrhea around 830PM. Temp to 104. Mom call ER & MD, but did not take child to either.


Changed on 9/14/2018

VAERS ID: 26913 Before After
VAERS Form:1
Age:2.0
Sex:Male
Location:Alabama
Vaccinated:1990-11-26
Onset:1990-11-26
Submitted:1990-11-28
Entered:1990-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 281947 / 3 RL / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1879S / 1 LA / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 283938 / 3 MO / PO

Administered by: Public      Purchased by: Other
Symptoms: Diarrhoea, Pyrexia, Vomiting

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: PPD vaccine by Connaught Lot# 231912
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': AL900003

Write-up: Pt vaccinated with DTP/OPV/MMR began vomiting & diarrhea around 830PM. Temp to 104. Mom call ER & MD, but did not take child to either.


Changed on 10/14/2018

VAERS ID: 26913 Before After
VAERS Form:1
Age:2.0
Sex:Male
Location:Alabama
Vaccinated:1990-11-26
Onset:1990-11-26
Submitted:1990-11-28
Entered:1990-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 281947 / 3 RL / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1879S / 1 LA / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 283938 / 3 MO / PO

Administered by: Public      Purchased by: Other
Symptoms: Diarrhoea, Pyrexia, Vomiting

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: PPD vaccine by Connaught Lot# 231912
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': AL900003

Write-up: Pt vaccinated with DTP/OPV/MMR began vomiting & diarrhea around 830PM. Temp to 104. Mom call ER & MD, but did not take child to either.

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