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| VAERS ID | 25001 | Vaccination Date: | 1990-06-04 | | Age | 0.2 | Onset Date: | 1990-06-04 Days later: 0 | | Sex | F | Submitted: | 0000-00-00 | | State | WI | Entered: | 1990-07-05 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: | | Preexisting Conditions: | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | DTP | CONNAUGHT LABS | 9Q01042 | | IM | | |
| Administered by: PVT Purchased by: UNK | | Symptoms: AGITATION | | Loud intense cry with screaming for 1 1/2 hrs. Seen next day, child normal. |
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| VAERS ID | 25016 | Vaccination Date: | 1986-02-09 | | Age | 0.3 | Onset Date: | 1986-02-09 Days later: 0 | | Sex | F | Submitted: | 0000-00-00 | | State | GA | Entered: | 1990-07-10 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? Yes |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: initially all lab data WNL; EEG normal, however over period 1986-1988 EEG has turned markedly abnormal, all lab studies WNL | | Previous Vaccinations: | | Other Medications: | | Preexisting Conditions: | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | DTP | LEDERLE | | | | | |
| Administered by: PVT Purchased by: UNK | | Symptoms: CONVULS GRAND MAL EEG ABNORM FEVER MENTAL RETARD | | 4 mon. infant given DTP 6Feb86- no problems until 9FEB86 awoke w/ fever 103F seen by MD normal exam. 18 hrs later generalized tonic-clonic seizure thought to be febrile, 2nd seizure 17Mar86, 3rd 3Apr86, child has developmental delay. |
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| VAERS ID | 25107 | Vaccination Date: | 1989-11-28 | | Age | 0.4 | Onset Date: | 1989-11-28 Days later: 0 | | Sex | F | Submitted: | 0000-00-00 | | State | MD | Entered: | 1990-07-09 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: | | Preexisting Conditions: | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | DTP | LEDERLE | 229976 | | | | | OPV | LEDERLE | 238938 | | | | |
| Administered by: UNK Purchased by: UNK | | Symptoms: FEVER SCREAMING SYND | | Fever 104 and screaming episode lasting appproximately 3 hrs following DTP/OPV immunization. |
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| VAERS ID | 25108 | Vaccination Date: | 0000-00-00 | | Age | 0.3 | Onset Date: | 1989-10-01 Days later: | | Sex | F | Submitted: | 0000-00-00 | | State | DE | Entered: | 1990-07-09 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: | | Preexisting Conditions: | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | DTP | LEDERLE | 256963 | | | | | OPV | LEDERLE | 10598A | | | | |
| Administered by: UNK Purchased by: UNK | | Symptoms: INJECT SITE REACT | | 4 Month old infant developed injection site reactionwithin 24 hrs after DTP/OPV immunization. |
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| VAERS ID | 25110 | Vaccination Date: | 1989-12-06 | | Age | 0.1 | Onset Date: | 1989-12-06 Days later: 0 | | Sex | F | Submitted: | 0000-00-00 | | State | NC | Entered: | 1990-07-09 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: | | Preexisting Conditions: | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | DTP | LEDERLE | 259966 | | | | | OPV | LEDERLE | 10598A | | | | |
| Administered by: PVT Purchased by: UNK | | Symptoms: SOMNOLENCE | | 2 Months old infant appeared sluggish, in a deep sleep and required stimulation for 20-25 minutes. Event occured 1 1/2 - 2 hrs after DTP/OPV immunization. |
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| VAERS ID | 25111 | Vaccination Date: | 1989-10-03 | | Age | 0.4 | Onset Date: | 1989-10-03 Days later: 0 | | Sex | F | Submitted: | 0000-00-00 | | State | MD | Entered: | 1990-07-09 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: | | Preexisting Conditions: | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | DTP | LEDERLE | 247979 | | | | | OPV | LEDERLE | 10594B | | | | |
| Administered by: UNK Purchased by: UNK | | Symptoms: FEVER SCREAMING SYND | | 6month old infant developed fever 103 and screaming episode for approximately 3 hrs following DTP/OPV immuniation |
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| VAERS ID | 25138 | Vaccination Date: | 1989-10-16 | | Age | 0.1 | Onset Date: | 1989-10-16 Days later: 0 | | Sex | F | Submitted: | 0000-00-00 | | State | WV | Entered: | 1990-07-09 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: TRI-IMMUNOL, ORIMUNE | | Preexisting Conditions: | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | DT | LEDERLE | 253963 | | | | |
| Administered by: PVT Purchased by: PVT | | Symptoms: DIARRHEA BLOODY | | INFANT RECEIVED 2ND DTP/OPV IMMUN 10-16-89. WITHIN 24 HOURS AFTER IMMUN PT EXPERIENCED BLOODY DIARRHEA LASTING 2 DAYS.PT EXPERIENCED SIMILAR EPISODE AFTER FIRST DTP/OPV IMMUN ON 8-18-89. RECHALLENGED |
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| VAERS ID | 25139 | Vaccination Date: | 1989-10-11 | | Age | 0.2 | Onset Date: | 1989-10-11 Days later: 0 | | Sex | F | Submitted: | 0000-00-00 | | State | IA | Entered: | 1990-07-09 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: | | Preexisting Conditions: | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | DT | LEDERLE | 256961 | | | | | DTP | LEDERLE | | | | | |
| Administered by: PVT Purchased by: PVT | | Symptoms: CONVULS CYANOSIS EYES GAZE UPWARD HYPERTONIA | | PT IMMUNIZED AT 10:30 AM AND AT 9:00PM PRESENTED IN ER. PARENTS REPORTED 6 TO 10 SEIZURES WHICH STARTED AT 7:30 PM. PT'S EYES ROLLED BACKWARDS BECAME STIFF AND TURNED BLUE. |
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| VAERS ID | 25140 | Vaccination Date: | 1989-10-11 | | Age | 0.0 | Onset Date: | 1989-10-11 Days later: 0 | | Sex | F | Submitted: | 0000-00-00 | | State | IL | Entered: | 1990-07-09 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? Yes (days in hospital: ) | | Extended hospital stay? No |
| Current Illness: | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: | | Preexisting Conditions: | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | DTP | LEDERLE | 256961 | | IM | | |
| Administered by: PVT Purchased by: PVT | | Symptoms: AGITATION APNEA HYPOTENS HYPOTONIA | | PT CRANKY NEXT 48 HRS AFTER IMMUN. BECAME LIMP AFTER 48 HRS. 3 EPISODES IN 3-4 HRS;MOTHER THOUGHT PT STOPPED BREATHING-NO COLOR CHANGE, NO SEIZURES, HOSPITALIZED-ABNORMAL PNEUMOGRAM. PT IMPROVED |
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| VAERS ID | 25164 | Vaccination Date: | 1990-01-04 | | Age | 0.0 | Onset Date: | 1990-01-10 Days later: 6 | | Sex | F | Submitted: | 0000-00-00 | | State | PA | Entered: | 1990-07-09 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: | | Preexisting Conditions: | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | DTP | LEDERLE | | | | | |
| Administered by: PVT Purchased by: PVT | | Symptoms: FEVER SCREAMING SYND TWITCH | | PT IMMUNIZED 1-4-90.1-10-90 PT EXPERIENCED JERKING MOVEMENTS INTERMITTENTLY FOR 18 HRS.HIGH PITCHED CRY FOR 24 HRS.TYLENOL GIVEN FOR LOW GRADE FEVER.OFFICE VISIT 1-10AND1-15;INFANT RECOVERED |
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