National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 27453

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 27453
VAERS Form:
Age:0.4
Sex:Male
Location:Arizona
Vaccinated:1990-08-14
Onset:1990-08-22
Submitted:1991-01-08
Entered:1991-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 256957 / 1 LL / -
OPV: ORIMUNE / LEDERLE 253948 / 1 - / PO

Administered by: Public      Purchased by: Unknown
Symptoms: FEVER, DIARRHEA, DEHYDRAT, COMA, ATROPHY MUSCLE

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1990-08-22
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: 21     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Surgery Jul90 for incarcarated hernia.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 1 wk following DTP/OPV #2 developed explosive diarrhea & temp 106.1, pale, unresponsive, kidney failure. Dx severe blood infection/diarrhea & dehydration was on peritoneal dialysis. Also dx w/ Wernig Hoffman Disease.


Changed on 12/8/2009

VAERS ID: 27453 Before After
VAERS Form:
Age:0.4
Sex:Male
Location:Arizona
Vaccinated:1990-08-14
Onset:1990-08-22
Submitted:1991-01-08
Entered:1991-01-22 1991-01-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL DTP (TRI-IMMUNOL) / LEDERLE LEDERLE LABORATORIES 256957 / 1 LL / -
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES 253948 / 1 - / PO

Administered by: Public      Purchased by: Unknown Public
Symptoms: Coma, Dehydration, Diarrhoea, Hypotonia, Muscle atrophy, Pallor, Paralysis, Pyrexia, Renal failure, Sepsis, FEVER, DIARRHEA, DEHYDRAT, COMA, ATROPHY MUSCLE

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1990-08-22
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: 21     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Surgery Jul90 for incarcarated hernia.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) AZ9101

Write-up: 1 wk following DTP/OPV #2 developed explosive diarrhea & temp 106.1, pale, unresponsive, kidney failure. Dx severe blood infection/diarrhea & dehydration was on peritoneal dialysis. Also dx w/ Wernig Hoffman Disease.


Changed on 5/14/2017

VAERS ID: 27453 Before After
VAERS Form:
Age:0.4
Sex:Male
Location:Arizona
Vaccinated:1990-08-14
Onset:1990-08-22
Submitted:1991-01-08
Entered:1991-01-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 256957 / 1 LL / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 253948 / 1 - / PO

Administered by: Public      Purchased by: Public
Symptoms: Coma, Dehydration, Diarrhoea, Hypotonia, Muscle atrophy, Pallor, Paralysis, Pyrexia, Renal failure, Sepsis

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1990-08-22
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: 21     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: Surgery Jul90 for incarcarated hernia.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': AZ9101

Write-up: 1 wk following DTP/OPV #2 developed explosive diarrhea & temp 106.1, pale, unresponsive, kidney failure. Dx severe blood infection/diarrhea & dehydration was on peritoneal dialysis. Also dx w/ Wernig Hoffman Disease.


Changed on 9/14/2017

VAERS ID: 27453 Before After
VAERS Form:(blank) 1
Age:0.4
Sex:Male
Location:Arizona
Vaccinated:1990-08-14
Onset:1990-08-22
Submitted:1991-01-08
Entered:1991-01-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 256957 / 1 2 LL / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 253948 / 1 2 - MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Coma, Dehydration, Diarrhoea, Hypotonia, Muscle atrophy, Pallor, Paralysis, Pyrexia, Renal failure, Sepsis

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1990-08-22
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: 21     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: Surgery Jul90 for incarcarated hernia.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': AZ9101

Write-up: 1 wk following DTP/OPV #2 developed explosive diarrhea & temp 106.1, pale, unresponsive, kidney failure. Dx severe blood infection/diarrhea & dehydration was on peritoneal dialysis. Also dx w/ Wernig Hoffman Disease.


Changed on 2/14/2018

VAERS ID: 27453 Before After
VAERS Form:1
Age:0.4
Sex:Male
Location:Arizona
Vaccinated:1990-08-14
Onset:1990-08-22
Submitted:1991-01-08
Entered:1991-01-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 256957 / 2 LL / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 253948 / 2 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Coma, Dehydration, Diarrhoea, Hypotonia, Muscle atrophy, Pallor, Paralysis, Pyrexia, Renal failure, Sepsis

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1990-08-22
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: 21     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: Surgery Jul90 for incarcarated hernia.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': AZ9101

Write-up: 1 wk following DTP/OPV #2 developed explosive diarrhea & temp 106.1, pale, unresponsive, kidney failure. Dx severe blood infection/diarrhea & dehydration was on peritoneal dialysis. Also dx w/ Wernig Hoffman Disease.


Changed on 6/14/2018

VAERS ID: 27453 Before After
VAERS Form:1
Age:0.4
Sex:Male
Location:Arizona
Vaccinated:1990-08-14
Onset:1990-08-22
Submitted:1991-01-08
Entered:1991-01-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 256957 / 2 LL / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 253948 / 2 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Coma, Dehydration, Diarrhoea, Hypotonia, Muscle atrophy, Pallor, Paralysis, Pyrexia, Renal failure, Sepsis

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1990-08-22
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: 21     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: Surgery Jul90 for incarcarated hernia.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': AZ9101

Write-up: 1 wk following DTP/OPV #2 developed explosive diarrhea & temp 106.1, pale, unresponsive, kidney failure. Dx severe blood infection/diarrhea & dehydration was on peritoneal dialysis. Also dx w/ Wernig Hoffman Disease.


Changed on 8/14/2018

VAERS ID: 27453 Before After
VAERS Form:1
Age:0.4
Sex:Male
Location:Arizona
Vaccinated:1990-08-14
Onset:1990-08-22
Submitted:1991-01-08
Entered:1991-01-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 256957 / 2 LL / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 253948 / 2 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Coma, Dehydration, Diarrhoea, Hypotonia, Muscle atrophy, Pallor, Paralysis, Pyrexia, Renal failure, Sepsis

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1990-08-22
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: 21     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: Surgery Jul90 for incarcarated hernia.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': AZ9101

Write-up: 1 wk following DTP/OPV #2 developed explosive diarrhea & temp 106.1, pale, unresponsive, kidney failure. Dx severe blood infection/diarrhea & dehydration was on peritoneal dialysis. Also dx w/ Wernig Hoffman Disease.


Changed on 9/14/2018

VAERS ID: 27453 Before After
VAERS Form:1
Age:0.4
Sex:Male
Location:Arizona
Vaccinated:1990-08-14
Onset:1990-08-22
Submitted:1991-01-08
Entered:1991-01-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 256957 / 2 LL / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 253948 / 2 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Coma, Dehydration, Diarrhoea, Hypotonia, Muscle atrophy, Pallor, Paralysis, Pyrexia, Renal failure, Sepsis

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1990-08-22
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: 21     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: Surgery Jul90 for incarcarated hernia.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': AZ9101

Write-up: 1 wk following DTP/OPV #2 developed explosive diarrhea & temp 106.1, pale, unresponsive, kidney failure. Dx severe blood infection/diarrhea & dehydration was on peritoneal dialysis. Also dx w/ Wernig Hoffman Disease.


Changed on 10/14/2018

VAERS ID: 27453 Before After
VAERS Form:1
Age:0.4
Sex:Male
Location:Arizona
Vaccinated:1990-08-14
Onset:1990-08-22
Submitted:1991-01-08
Entered:1991-01-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 256957 / 2 LL / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 253948 / 2 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Coma, Dehydration, Diarrhoea, Hypotonia, Muscle atrophy, Pallor, Paralysis, Pyrexia, Renal failure, Sepsis

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1990-08-22
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: 21     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: Surgery Jul90 for incarcarated hernia.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': AZ9101

Write-up: 1 wk following DTP/OPV #2 developed explosive diarrhea & temp 106.1, pale, unresponsive, kidney failure. Dx severe blood infection/diarrhea & dehydration was on peritoneal dialysis. Also dx w/ Wernig Hoffman Disease.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=27453&WAYBACKHISTORY=ON


Copyright © 2020 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166