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This is VAERS ID 27780

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 27780
VAERS Form:
Age:1.3
Sex:Female
Location:Maryland
Vaccinated:1990-08-29
Onset:1990-09-04
Submitted:1990-12-18
Entered:1991-02-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: PROHIBIT / CONNAUGHT LABS 0J11036 / 0 A / IM
MMR: MMR II / MSD 1499S / 0 A / SC

Administered by: Private      Purchased by: Unknown
Symptoms: TWITCH, ATAXIA

Life Threatening? No
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: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CAT Scan & bloodwork normal
CDC 'Split Type':

Write-up: Acute cerebellar ataxia onset 4SEP90 started w/head twitching,loss of balance, then was unable to walk. Admit hosp 7Sep90 & D/C 10Sep90, still under treatment.


Changed on 12/8/2009

VAERS ID: 27780 Before After
VAERS Form:
Age:1.3
Sex:Female
Location:Maryland
Vaccinated:1990-08-29
Onset:1990-09-04
Submitted:1990-12-18
Entered:1991-02-09 1991-02-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: PROHIBIT HIB (PROHIBIT) / CONNAUGHT LABS CONNAUGHT LABORATORIES 0J11036 / 0 A / IM
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 1499S / 0 A / SC

Administered by: Private      Purchased by: Unknown Private
Symptoms: Coordination abnormal, Muscle twitching, TWITCH, ATAXIA

Life Threatening? No
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: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CAT Scan & bloodwork normal
CDC 'Split Type': (blank) MD90122

Write-up: Acute cerebellar ataxia onset 4SEP90 started w/head twitching,loss of balance, then was unable to walk. Admit hosp 7Sep90 & D/C 10Sep90, still under treatment.


Changed on 5/14/2017

VAERS ID: 27780 Before After
VAERS Form:
Age:1.3
Sex:Female
Location:Maryland
Vaccinated:1990-08-29
Onset:1990-09-04
Submitted:1990-12-18
Entered:1991-02-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0J11036 / 0 A - / IM IM A
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1499S / 0 A - / SC SC A

Administered by: Private      Purchased by: Private
Symptoms: Coordination abnormal, Muscle twitching

Life Threatening? No
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: 3     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CAT Scan & bloodwork normal
CDC 'Split Type': MD90122

Write-up: Acute cerebellar ataxia onset 4SEP90 started w/head twitching,loss of balance, then was unable to walk. Admit hosp 7Sep90 & D/C 10Sep90, still under treatment.


Changed on 9/14/2017

VAERS ID: 27780 Before After
VAERS Form:(blank) 1
Age:1.3
Sex:Female
Location:Maryland
Vaccinated:1990-08-29
Onset:1990-09-04
Submitted:1990-12-18
Entered:1991-02-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0J11036 / 0 1 - / IM A
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1499S / 0 1 - / SC A

Administered by: Private      Purchased by: Private
Symptoms: Coordination abnormal, Muscle twitching

Life Threatening? No
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: 3     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CAT Scan & bloodwork normal
CDC 'Split Type': MD90122

Write-up: Acute cerebellar ataxia onset 4SEP90 started w/head twitching,loss of balance, then was unable to walk. Admit hosp 7Sep90 & D/C 10Sep90, still under treatment.


Changed on 2/14/2018

VAERS ID: 27780 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Maryland
Vaccinated:1990-08-29
Onset:1990-09-04
Submitted:1990-12-18
Entered:1991-02-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0J11036 / 1 - / IM A
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1499S / 1 - / SC A

Administered by: Private      Purchased by: Private
Symptoms: Coordination abnormal, Muscle twitching

Life Threatening? No
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: 3     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CAT Scan & bloodwork normal
CDC 'Split Type': MD90122

Write-up: Acute cerebellar ataxia onset 4SEP90 started w/head twitching,loss of balance, then was unable to walk. Admit hosp 7Sep90 & D/C 10Sep90, still under treatment.


Changed on 6/14/2018

VAERS ID: 27780 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Maryland
Vaccinated:1990-08-29
Onset:1990-09-04
Submitted:1990-12-18
Entered:1991-02-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0J11036 / 1 - / IM A
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1499S / 1 - / SC A

Administered by: Private      Purchased by: Private
Symptoms: Coordination abnormal, Muscle twitching

Life Threatening? No
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: 3     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CAT Scan & bloodwork normal
CDC 'Split Type': MD90122

Write-up: Acute cerebellar ataxia onset 4SEP90 started w/head twitching,loss of balance, then was unable to walk. Admit hosp 7Sep90 & D/C 10Sep90, still under treatment.


Changed on 8/14/2018

VAERS ID: 27780 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Maryland
Vaccinated:1990-08-29
Onset:1990-09-04
Submitted:1990-12-18
Entered:1991-02-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0J11036 / 1 - / IM A
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1499S / 1 - / SC A

Administered by: Private      Purchased by: Private
Symptoms: Coordination abnormal, Muscle twitching

Life Threatening? No
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: 3     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CAT Scan & bloodwork normal
CDC 'Split Type': MD90122

Write-up: Acute cerebellar ataxia onset 4SEP90 started w/head twitching,loss of balance, then was unable to walk. Admit hosp 7Sep90 & D/C 10Sep90, still under treatment.


Changed on 9/14/2018

VAERS ID: 27780 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Maryland
Vaccinated:1990-08-29
Onset:1990-09-04
Submitted:1990-12-18
Entered:1991-02-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0J11036 / 1 - / IM A
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1499S / 1 - / SC A

Administered by: Private      Purchased by: Private
Symptoms: Coordination abnormal, Muscle twitching

Life Threatening? No
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: 3     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CAT Scan & bloodwork normal
CDC 'Split Type': MD90122

Write-up: Acute cerebellar ataxia onset 4SEP90 started w/head twitching,loss of balance, then was unable to walk. Admit hosp 7Sep90 & D/C 10Sep90, still under treatment.


Changed on 10/14/2018

VAERS ID: 27780 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Maryland
Vaccinated:1990-08-29
Onset:1990-09-04
Submitted:1990-12-18
Entered:1991-02-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0J11036 / 1 - / IM A
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1499S / 1 - / SC A

Administered by: Private      Purchased by: Private
Symptoms: Coordination abnormal, Muscle twitching

Life Threatening? No
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: 3     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CAT Scan & bloodwork normal
CDC 'Split Type': MD90122

Write-up: Acute cerebellar ataxia onset 4SEP90 started w/head twitching,loss of balance, then was unable to walk. Admit hosp 7Sep90 & D/C 10Sep90, still under treatment.

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