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This is VAERS ID 25966

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 25966
VAERS Form:
Age:1.3
Sex:Female
Location:North Carolina
Vaccinated:1990-09-06
Onset:1990-09-07
Submitted:1990-09-07
Entered:1990-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 283971 / 3 LL / -
MMR: MMR II / MSD 2269R / - LA / -
OPV: ORIMUNE / LEDERLE 277940 / 2 - / PO

Administered by: Public      Purchased by: Unknown
Symptoms: CONVULS, FEVER

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: pt also rec''d tine test, lt forearm at same time as vax.
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: LP Normal, EEG Normal, MRI Normal
CDC 'Split Type':

Write-up: Pt vaccinated with MMR/DPT/OPV/Tine test had tonic-clonic seizures (X4) beginning 3:00 am to 7:30 am on 7SEP90. Max. T 101.8 per parents. @ ER T 101.7. Longest seizure about 2 min.


Changed on 12/8/2009

VAERS ID: 25966 Before After
VAERS Form:
Age:1.3
Sex:Female
Location:North Carolina
Vaccinated:1990-09-06
Onset:1990-09-07
Submitted:1990-09-07
Entered:1990-09-20 1990-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL DTP (TRI-IMMUNOL) / LEDERLE LEDERLE LABORATORIES 283971 / 3 LL / -
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 2269R / - LA / -
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES 277940 / 2 - / PO

Administered by: Public      Purchased by: Unknown Public
Symptoms: Convulsion, Pyrexia, CONVULS, FEVER

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: pt also rec''d tine test, lt forearm at same time as vax.
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: LP Normal, EEG Normal, MRI Normal
CDC 'Split Type':

Write-up: Pt vaccinated with MMR/DPT/OPV/Tine test had tonic-clonic seizures (X4) beginning 3:00 am to 7:30 am on 7SEP90. Max. T 101.8 per parents. @ ER T 101.7. Longest seizure about 2 min.


Changed on 5/14/2017

VAERS ID: 25966 Before After
VAERS Form:
Age:1.3
Sex:Female
Location:North Carolina
Vaccinated:1990-09-06
Onset:1990-09-07
Submitted:1990-09-07
Entered:1990-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 283971 / 3 LL / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 2269R / - LA / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 277940 / 2 - / PO

Administered by: Public      Purchased by: Public
Symptoms: Convulsion, Pyrexia

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: pt also rec''d tine test, lt forearm at same time as vax.
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: LP Normal, EEG Normal, MRI Normal
CDC 'Split Type':

Write-up: Pt vaccinated with MMR/DPT/OPV/Tine test had tonic-clonic seizures (X4) beginning 3:00 am to 7:30 am on 7SEP90. Max. T 101.8 per parents. @ ER T 101.7. Longest seizure about 2 min.


Changed on 9/14/2017

VAERS ID: 25966 Before After
VAERS Form:(blank) 1
Age:1.3
Sex:Female
Location:North Carolina
Vaccinated:1990-09-06
Onset:1990-09-07
Submitted:1990-09-07
Entered:1990-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 283971 / 3 4 LL / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 2269R / - UNK LA / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 277940 / 2 3 - MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Convulsion, Pyrexia

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: pt also rec''d tine test, lt forearm at same time as vax.
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: LP Normal, EEG Normal, MRI Normal
CDC 'Split Type':

Write-up: Pt vaccinated with MMR/DPT/OPV/Tine test had tonic-clonic seizures (X4) beginning 3:00 am to 7:30 am on 7SEP90. Max. T 101.8 per parents. @ ER T 101.7. Longest seizure about 2 min.


Changed on 2/14/2018

VAERS ID: 25966 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:North Carolina
Vaccinated:1990-09-06
Onset:1990-09-07
Submitted:1990-09-07
Entered:1990-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 283971 / 4 LL / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 2269R / UNK LA / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 277940 / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Convulsion, Pyrexia

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: pt also rec''d tine test, lt forearm at same time as vax.
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: LP Normal, EEG Normal, MRI Normal
CDC 'Split Type':

Write-up: Pt vaccinated with MMR/DPT/OPV/Tine test had tonic-clonic seizures (X4) beginning 3:00 am to 7:30 am on 7SEP90. Max. T 101.8 per parents. @ ER T 101.7. Longest seizure about 2 min.


Changed on 6/14/2018

VAERS ID: 25966 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:North Carolina
Vaccinated:1990-09-06
Onset:1990-09-07
Submitted:1990-09-07
Entered:1990-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 283971 / 4 LL / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 2269R / UNK LA / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 277940 / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Convulsion, Pyrexia

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: pt also rec''d tine test, lt forearm at same time as vax.
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: LP Normal, EEG Normal, MRI Normal
CDC 'Split Type':

Write-up: Pt vaccinated with MMR/DPT/OPV/Tine test had tonic-clonic seizures (X4) beginning 3:00 am to 7:30 am on 7SEP90. Max. T 101.8 per parents. @ ER T 101.7. Longest seizure about 2 min.


Changed on 8/14/2018

VAERS ID: 25966 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:North Carolina
Vaccinated:1990-09-06
Onset:1990-09-07
Submitted:1990-09-07
Entered:1990-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 283971 / 4 LL / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 2269R / UNK LA / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 277940 / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Convulsion, Pyrexia

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: pt also rec''d tine test, lt forearm at same time as vax.
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: LP Normal, EEG Normal, MRI Normal
CDC 'Split Type':

Write-up: Pt vaccinated with MMR/DPT/OPV/Tine test had tonic-clonic seizures (X4) beginning 3:00 am to 7:30 am on 7SEP90. Max. T 101.8 per parents. @ ER T 101.7. Longest seizure about 2 min.


Changed on 9/14/2018

VAERS ID: 25966 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:North Carolina
Vaccinated:1990-09-06
Onset:1990-09-07
Submitted:1990-09-07
Entered:1990-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 283971 / 4 LL / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 2269R / UNK LA / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 277940 / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Convulsion, Pyrexia

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: pt also rec''d tine test, lt forearm at same time as vax.
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: LP Normal, EEG Normal, MRI Normal
CDC 'Split Type':

Write-up: Pt vaccinated with MMR/DPT/OPV/Tine test had tonic-clonic seizures (X4) beginning 3:00 am to 7:30 am on 7SEP90. Max. T 101.8 per parents. @ ER T 101.7. Longest seizure about 2 min.


Changed on 10/14/2018

VAERS ID: 25966 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:North Carolina
Vaccinated:1990-09-06
Onset:1990-09-07
Submitted:1990-09-07
Entered:1990-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 283971 / 4 LL / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 2269R / UNK LA / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 277940 / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Convulsion, Pyrexia

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: pt also rec''d tine test, lt forearm at same time as vax.
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: LP Normal, EEG Normal, MRI Normal
CDC 'Split Type':

Write-up: Pt vaccinated with MMR/DPT/OPV/Tine test had tonic-clonic seizures (X4) beginning 3:00 am to 7:30 am on 7SEP90. Max. T 101.8 per parents. @ ER T 101.7. Longest seizure about 2 min.

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=25966&WAYBACKHISTORY=ON


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