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This is VAERS ID 31009

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 31009
VAERS Form:
Age:1.5
Sex:Male
Location:South Dakota
Vaccinated:1990-02-13
Onset:1990-02-17
Submitted:1991-05-18
Entered:1991-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 241920 / 3 - / IM
HIBV: HIBTITER / LEDERLE(PRAXIS) - / 0 - / IM
OPV: ORIMUNE / LEDERLE 247945 / 2 - / PO

Administered by: Private      Purchased by: Unknown
Symptoms: FEVER, SOMNOLENCE, SPEECH DIS, AUTISM

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CXR- normal; Strep test - negative; Blood bacteria culture - negative;
CDC 'Split Type': NONE

Write-up: 4days post vax devl running fever; to ER t104 & very lathargic; several tests for various things & couldn''t find anything wrong; given antibiotics as precaution; then lost speech & was dx w/autism in DEC90;


Changed on 12/8/2009

VAERS ID: 31009 Before After
VAERS Form:
Age:1.5
Sex:Male
Location:South Dakota
Vaccinated:1990-02-13
Onset:1990-02-17
Submitted:1991-05-18
Entered:1991-06-07 1991-06-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL DTP (TRI-IMMUNOL) / LEDERLE LEDERLE LABORATORIES 241920 / 3 - / IM
HIBV: HIBTITER HIB (HIBTITER) / LEDERLE(PRAXIS) LEDERLE PRAXSIS - / 0 - / IM
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES 247945 / 2 - / PO

Administered by: Private      Purchased by: Unknown
Symptoms: Autism, Pyrexia, Somnolence, Speech disorder, FEVER, SOMNOLENCE, SPEECH DIS, AUTISM

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CXR- normal; Strep test - negative; Blood bacteria culture - negative;
CDC 'Split Type': NONE (blank)

Write-up: 4days post vax devl running fever; to ER t104 & very lathargic; several tests for various things & couldn''t find anything wrong; given antibiotics as precaution; then lost speech & was dx w/autism in DEC90;


Changed on 5/14/2017

VAERS ID: 31009 Before After
VAERS Form:
Age:1.5
Sex:Male
Location:South Dakota
Vaccinated:1990-02-13
Onset:1990-02-17
Submitted:1991-05-18
Entered:1991-06-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 241920 / 3 - / IM
HIBV: HIB (HIBTITER) / LEDERLE PRAXSIS PFIZER/WYETH - / 0 - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 247945 / 2 - / PO

Administered by: Private      Purchased by: Unknown
Symptoms: Autism, Pyrexia, Somnolence, Speech disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE NONE~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CXR- normal; Strep test - negative; Blood bacteria culture - negative;
CDC 'Split Type':

Write-up: 4days post vax devl running fever; to ER t104 & very lathargic; several tests for various things & couldn''t find anything wrong; given antibiotics as precaution; then lost speech & was dx w/autism in DEC90;


Changed on 9/14/2017

VAERS ID: 31009 Before After
VAERS Form:(blank) 1
Age:1.5
Sex:Male
Location:South Dakota
Vaccinated:1990-02-13
Onset:1990-02-17
Submitted:1991-05-18
Entered:1991-06-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 241920 / 3 4 - / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH - / 0 1 - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 247945 / 2 3 - MO / PO

Administered by: Private      Purchased by: Unknown
Symptoms: Autism, Pyrexia, Somnolence, Speech disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CXR- normal; Strep test - negative; Blood bacteria culture - negative;
CDC 'Split Type':

Write-up: 4days post vax devl running fever; to ER t104 & very lathargic; several tests for various things & couldn''t find anything wrong; given antibiotics as precaution; then lost speech & was dx w/autism in DEC90;


Changed on 2/14/2018

VAERS ID: 31009 Before After
VAERS Form:1
Age:1.5
Sex:Male
Location:South Dakota
Vaccinated:1990-02-13
Onset:1990-02-17
Submitted:1991-05-18
Entered:1991-06-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 241920 / 4 - / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH - / 1 - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 247945 / 3 MO / PO

Administered by: Private      Purchased by: Unknown
Symptoms: Autism, Pyrexia, Somnolence, Speech disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CXR- normal; Strep test - negative; Blood bacteria culture - negative;
CDC 'Split Type':

Write-up: 4days post vax devl running fever; to ER t104 & very lathargic; several tests for various things & couldn''t find anything wrong; given antibiotics as precaution; then lost speech & was dx w/autism in DEC90;


Changed on 6/14/2018

VAERS ID: 31009 Before After
VAERS Form:1
Age:1.5
Sex:Male
Location:South Dakota
Vaccinated:1990-02-13
Onset:1990-02-17
Submitted:1991-05-18
Entered:1991-06-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 241920 / 4 - / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH - / 1 - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 247945 / 3 MO / PO

Administered by: Private      Purchased by: Unknown
Symptoms: Autism, Pyrexia, Somnolence, Speech disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CXR- normal; Strep test - negative; Blood bacteria culture - negative;
CDC 'Split Type':

Write-up: 4days post vax devl running fever; to ER t104 & very lathargic; several tests for various things & couldn''t find anything wrong; given antibiotics as precaution; then lost speech & was dx w/autism in DEC90;


Changed on 8/14/2018

VAERS ID: 31009 Before After
VAERS Form:1
Age:1.5
Sex:Male
Location:South Dakota
Vaccinated:1990-02-13
Onset:1990-02-17
Submitted:1991-05-18
Entered:1991-06-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 241920 / 4 - / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH - / 1 - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 247945 / 3 MO / PO

Administered by: Private      Purchased by: Unknown
Symptoms: Autism, Pyrexia, Somnolence, Speech disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CXR- normal; Strep test - negative; Blood bacteria culture - negative;
CDC 'Split Type':

Write-up: 4days post vax devl running fever; to ER t104 & very lathargic; several tests for various things & couldn''t find anything wrong; given antibiotics as precaution; then lost speech & was dx w/autism in DEC90;


Changed on 9/14/2018

VAERS ID: 31009 Before After
VAERS Form:1
Age:1.5
Sex:Male
Location:South Dakota
Vaccinated:1990-02-13
Onset:1990-02-17
Submitted:1991-05-18
Entered:1991-06-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 241920 / 4 - / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH - / 1 - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 247945 / 3 MO / PO

Administered by: Private      Purchased by: Unknown
Symptoms: Autism, Pyrexia, Somnolence, Speech disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CXR- normal; Strep test - negative; Blood bacteria culture - negative;
CDC 'Split Type':

Write-up: 4days post vax devl running fever; to ER t104 & very lathargic; several tests for various things & couldn''t find anything wrong; given antibiotics as precaution; then lost speech & was dx w/autism in DEC90;


Changed on 10/14/2018

VAERS ID: 31009 Before After
VAERS Form:1
Age:1.5
Sex:Male
Location:South Dakota
Vaccinated:1990-02-13
Onset:1990-02-17
Submitted:1991-05-18
Entered:1991-06-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 241920 / 4 - / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH - / 1 - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 247945 / 3 MO / PO

Administered by: Private      Purchased by: Unknown
Symptoms: Autism, Pyrexia, Somnolence, Speech disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CXR- normal; Strep test - negative; Blood bacteria culture - negative;
CDC 'Split Type':

Write-up: 4days post vax devl running fever; to ER t104 & very lathargic; several tests for various things & couldn''t find anything wrong; given antibiotics as precaution; then lost speech & was dx w/autism in DEC90;

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=31009&WAYBACKHISTORY=ON


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