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This is VAERS ID 25941

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 25941
VAERS Form:
Age:1.3
Gender:Male
Location:Pennsylvania
Vaccinated:1990-02-12
Onset:1990-02-18
Submitted:1990-09-10
Entered:1990-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II / MSD - / - L / IM

Administered by: Private      Purchased by: Unknown
Symptoms: AGITATION, HYPOKINESIA, CONVULS, FEVER, SOMNOLENCE

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: EEG normal; Spinal tap normal
CDC 'Split Type':

Write-up: Pt vaccinated with MMR 7 day later developed irritability, fever 103AX, decreased alertness with seizure like activity with arm twitching & lethargy.


Changed on 12/8/2009

VAERS ID: 25941 Before After
VAERS Form:
Age:1.3
Gender:Male
Location:Pennsylvania
Vaccinated:1990-02-12
Onset:1990-02-18
Submitted:1990-09-10
Entered:1990-09-19 1990-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. - / - L / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Agitation, Convulsion, Hypokinesia, Muscle twitching, Pyrexia, Somnolence, AGITATION, HYPOKINESIA, CONVULS, FEVER, SOMNOLENCE

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: EEG normal; Spinal tap normal
CDC 'Split Type':

Write-up: Pt vaccinated with MMR 7 day later developed irritability, fever 103AX, decreased alertness with seizure like activity with arm twitching & lethargy.


Changed on 5/14/2017

VAERS ID: 25941 Before After
VAERS Form:
Age:1.3
Gender:Male
Location:Pennsylvania
Vaccinated:1990-02-12
Onset:1990-02-18
Submitted:1990-09-10
Entered:1990-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / - L - / IM IM L

Administered by: Private      Purchased by: Private
Symptoms: Agitation, Convulsion, Hypokinesia, Muscle twitching, Pyrexia, Somnolence

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: EEG normal; Spinal tap normal
CDC 'Split Type':

Write-up: Pt vaccinated with MMR 7 day later developed irritability, fever 103AX, decreased alertness with seizure like activity with arm twitching & lethargy.


Changed on 9/14/2017

VAERS ID: 25941 Before After
VAERS Form:(blank) 1
Age:1.3
Gender:Male
Location:Pennsylvania
Vaccinated:1990-02-12
Onset:1990-02-18
Submitted:1990-09-10
Entered:1990-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / - UNK - / IM L

Administered by: Private      Purchased by: Private
Symptoms: Agitation, Convulsion, Hypokinesia, Muscle twitching, Pyrexia, Somnolence

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: EEG normal; Spinal tap normal
CDC 'Split Type':

Write-up: Pt vaccinated with MMR 7 day later developed irritability, fever 103AX, decreased alertness with seizure like activity with arm twitching & lethargy.


Changed on 2/14/2018

VAERS ID: 25941 Before After
VAERS Form:1
Age:1.3
Gender:Male
Location:Pennsylvania
Vaccinated:1990-02-12
Onset:1990-02-18
Submitted:1990-09-10
Entered:1990-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / IM L

Administered by: Private      Purchased by: Private
Symptoms: Agitation, Convulsion, Hypokinesia, Muscle twitching, Pyrexia, Somnolence

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: EEG normal; Spinal tap normal
CDC 'Split Type':

Write-up: Pt vaccinated with MMR 7 day later developed irritability, fever 103AX, decreased alertness with seizure like activity with arm twitching & lethargy.


Changed on 6/14/2018

VAERS ID: 25941 Before After
VAERS Form:1
Age:1.3
Gender:Male
Location:Pennsylvania
Vaccinated:1990-02-12
Onset:1990-02-18
Submitted:1990-09-10
Entered:1990-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / IM L

Administered by: Private      Purchased by: Private
Symptoms: Agitation, Convulsion, Hypokinesia, Muscle twitching, Pyrexia, Somnolence

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: EEG normal; Spinal tap normal
CDC 'Split Type':

Write-up: Pt vaccinated with MMR 7 day later developed irritability, fever 103AX, decreased alertness with seizure like activity with arm twitching & lethargy.


Changed on 8/14/2018

VAERS ID: 25941 Before After
VAERS Form:1
Age:1.3
Gender:Male
Location:Pennsylvania
Vaccinated:1990-02-12
Onset:1990-02-18
Submitted:1990-09-10
Entered:1990-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / IM L

Administered by: Private      Purchased by: Private
Symptoms: Agitation, Convulsion, Hypokinesia, Muscle twitching, Pyrexia, Somnolence

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: EEG normal; Spinal tap normal
CDC 'Split Type':

Write-up: Pt vaccinated with MMR 7 day later developed irritability, fever 103AX, decreased alertness with seizure like activity with arm twitching & lethargy.


Changed on 9/14/2018

VAERS ID: 25941 Before After
VAERS Form:1
Age:1.3
Gender:Male
Location:Pennsylvania
Vaccinated:1990-02-12
Onset:1990-02-18
Submitted:1990-09-10
Entered:1990-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / IM L

Administered by: Private      Purchased by: Private
Symptoms: Agitation, Convulsion, Hypokinesia, Muscle twitching, Pyrexia, Somnolence

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: EEG normal; Spinal tap normal
CDC 'Split Type':

Write-up: Pt vaccinated with MMR 7 day later developed irritability, fever 103AX, decreased alertness with seizure like activity with arm twitching & lethargy.


Changed on 10/14/2018

VAERS ID: 25941 Before After
VAERS Form:1
Age:1.3
Gender:Male
Location:Pennsylvania
Vaccinated:1990-02-12
Onset:1990-02-18
Submitted:1990-09-10
Entered:1990-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / IM L

Administered by: Private      Purchased by: Private
Symptoms: Agitation, Convulsion, Hypokinesia, Muscle twitching, Pyrexia, Somnolence

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: EEG normal; Spinal tap normal
CDC 'Split Type':

Write-up: Pt vaccinated with MMR 7 day later developed irritability, fever 103AX, decreased alertness with seizure like activity with arm twitching & lethargy.

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