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This is VAERS ID 25287

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 25287
VAERS Form:
Age:1.3
Sex:Female
Location:Ohio
Vaccinated:1990-06-20
Onset:1990-06-28
Submitted:0000-00-00
Entered:1990-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 279946 / - - / IM
MMR: MMR II / MSD 1227S / - - / SC

Administered by: Private      Purchased by: Unknown
Symptoms: CONVULS

Life Threatening? No
Birth Defect? No
Died? No
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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Past history of seizure /w fever
Allergies:
Diagnostic Lab Data: Normal electrolytes, CBC serum glucose & calcium
CDC 'Split Type':

Write-up: Tonic seizure activity involving the rt leg & arm. Head & eyes drawn to rt


Changed on 12/8/2009

VAERS ID: 25287 Before After
VAERS Form:
Age:1.3
Sex:Female
Location:Ohio
Vaccinated:1990-06-20
Onset:1990-06-28
Submitted:0000-00-00
Entered:1990-07-17 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL DTP (TRI-IMMUNOL) / LEDERLE LEDERLE LABORATORIES 279946 / - - / IM
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 1227S / - - / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion, CONVULS

Life Threatening? No
Birth Defect? No
Died? No
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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Past history of seizure /w fever
Allergies:
Diagnostic Lab Data: Normal electrolytes, CBC serum glucose & calcium
CDC 'Split Type':

Write-up: Tonic seizure activity involving the rt leg & arm. Head & eyes drawn to rt


Changed on 5/14/2017

VAERS ID: 25287 Before After
VAERS Form:
Age:1.3
Sex:Female
Location:Ohio
Vaccinated:1990-06-20
Onset:1990-06-28
Submitted:0000-00-00
Entered:1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 279946 / - - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1227S / - - / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion

Life Threatening? No
Birth Defect? No
Died? No
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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: Past history of seizure /w fever
Allergies:
Diagnostic Lab Data: Normal electrolytes, CBC serum glucose & calcium
CDC 'Split Type':

Write-up: Tonic seizure activity involving the rt leg & arm. Head & eyes drawn to rt


Changed on 9/14/2017

VAERS ID: 25287 Before After
VAERS Form:(blank) 1
Age:1.3
Sex:Female
Location:Ohio
Vaccinated:1990-06-20
Onset:1990-06-28
Submitted:0000-00-00
Entered:1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 279946 / - UNK - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1227S / - UNK - / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion

Life Threatening? No
Birth Defect? No
Died? No
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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: Past history of seizure /w fever
Allergies:
Diagnostic Lab Data: Normal electrolytes, CBC serum glucose & calcium
CDC 'Split Type':

Write-up: Tonic seizure activity involving the rt leg & arm. Head & eyes drawn to rt


Changed on 2/14/2018

VAERS ID: 25287 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Ohio
Vaccinated:1990-06-20
Onset:1990-06-28
Submitted:0000-00-00
Entered:1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 279946 / UNK - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1227S / UNK - / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion

Life Threatening? No
Birth Defect? No
Died? No
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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: Past history of seizure /w fever
Allergies:
Diagnostic Lab Data: Normal electrolytes, CBC serum glucose & calcium
CDC 'Split Type':

Write-up: Tonic seizure activity involving the rt leg & arm. Head & eyes drawn to rt


Changed on 6/14/2018

VAERS ID: 25287 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Ohio
Vaccinated:1990-06-20
Onset:1990-06-28
Submitted:0000-00-00
Entered:1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 279946 / UNK - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1227S / UNK - / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion

Life Threatening? No
Birth Defect? No
Died? No
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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: Past history of seizure /w fever
Allergies:
Diagnostic Lab Data: Normal electrolytes, CBC serum glucose & calcium
CDC 'Split Type':

Write-up: Tonic seizure activity involving the rt leg & arm. Head & eyes drawn to rt


Changed on 8/14/2018

VAERS ID: 25287 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Ohio
Vaccinated:1990-06-20
Onset:1990-06-28
Submitted:0000-00-00
Entered:1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 279946 / UNK - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1227S / UNK - / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion

Life Threatening? No
Birth Defect? No
Died? No
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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: Past history of seizure /w fever
Allergies:
Diagnostic Lab Data: Normal electrolytes, CBC serum glucose & calcium
CDC 'Split Type':

Write-up: Tonic seizure activity involving the rt leg & arm. Head & eyes drawn to rt


Changed on 9/14/2018

VAERS ID: 25287 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Ohio
Vaccinated:1990-06-20
Onset:1990-06-28
Submitted:0000-00-00
Entered:1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 279946 / UNK - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1227S / UNK - / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion

Life Threatening? No
Birth Defect? No
Died? No
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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: Past history of seizure /w fever
Allergies:
Diagnostic Lab Data: Normal electrolytes, CBC serum glucose & calcium
CDC 'Split Type':

Write-up: Tonic seizure activity involving the rt leg & arm. Head & eyes drawn to rt


Changed on 10/14/2018

VAERS ID: 25287 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Ohio
Vaccinated:1990-06-20
Onset:1990-06-28
Submitted:0000-00-00
Entered:1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 279946 / UNK - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1227S / UNK - / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion

Life Threatening? No
Birth Defect? No
Died? No
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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: Past history of seizure /w fever
Allergies:
Diagnostic Lab Data: Normal electrolytes, CBC serum glucose & calcium
CDC 'Split Type':

Write-up: Tonic seizure activity involving the rt leg & arm. Head & eyes drawn to rt

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