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This is VAERS ID 25006

Case Details

VAERS ID: 25006 (history)  
Form: Version 1.0  
Age: 16.0  
Gender: Female  
Location: Ohio  
Vaccinated:1989-11-17
Onset:1989-11-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
TD: TD ADSORBED (NO BRAND NAME) / LEDERLE LABORATORIES 247953 / UNK - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Convulsion, Dizziness
SMQs:, Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: no hx of local or systemic rxns
Allergies:
Diagnostic Lab Data:
CDC Split Type: 890278001

Write-up: 16 yr old female feeling faint & then had seizure within a few min. /p Td/MMR immunization. MD is uncertain if seizure was due to hyperventilation episode. No treatment initiated. Pt asymptomatic. Vaccine given routine


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