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This is VAERS ID 30060

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 30060
VAERS Form:
Age:1.3
Sex:Male
Location:Minnesota
Vaccinated:1991-03-26
Onset:1991-03-27
Submitted:1991-04-18
Entered:1991-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIBTITER / LEDERLE(PRAXIS) M685EN / - RL / IM
MMR: MMR II / MSD 1929S / - LL / SC

Administered by: Private      Purchased by: Unknown
Symptoms: CONVULS, VOMIT, TWITCH, STUPOR, DIARRHEA

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Normal EEG, Normal CT SCAN, Normal Blood work, Lytes, CA Gluc, Mg
CDC 'Split Type': NONE

Write-up: 4hrs post vax developed v, d 6x each between 6PM & 7AM; no fever, febrile sz, arched back legs stiff no clonus, eye dilated & ""empty look"", ? lt cheek & lt arm twitching;


Changed on 12/8/2009

VAERS ID: 30060 Before After
VAERS Form:
Age:1.3
Sex:Male
Location:Minnesota
Vaccinated:1991-03-26
Onset:1991-03-27
Submitted:1991-04-18
Entered:1991-04-26 1991-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIBTITER HIB (HIBTITER) / LEDERLE(PRAXIS) LEDERLE PRAXSIS M685EN / - RL / IM
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 1929S / - LL / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion, Diarrhoea, Muscle twitching, Stupor, Vomiting, CONVULS, VOMIT, TWITCH, STUPOR, DIARRHEA

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Normal EEG, Normal CT SCAN, Normal Blood work, Lytes, CA Gluc, Mg
CDC 'Split Type': NONE (blank)

Write-up: 4hrs post vax developed v, d 6x each between 6PM & 7AM; no fever, febrile sz, arched back legs stiff no clonus, eye dilated & ""empty look"", "empty look", ? lt cheek & lt arm twitching;


Changed on 5/14/2017

VAERS ID: 30060 Before After
VAERS Form:
Age:1.3
Sex:Male
Location:Minnesota
Vaccinated:1991-03-26
Onset:1991-03-27
Submitted:1991-04-18
Entered:1991-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / LEDERLE PRAXSIS PFIZER/WYETH M685EN / - RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1929S / - LL / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion, Diarrhoea, Muscle twitching, Stupor, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: NONE NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Normal EEG, Normal CT SCAN, Normal Blood work, Lytes, CA Gluc, Mg
CDC 'Split Type':

Write-up: 4hrs post vax developed v, d 6x each between 6PM & 7AM; no fever, febrile sz, arched back legs stiff no clonus, eye dilated & "empty look", ? lt cheek & lt arm twitching;


Changed on 9/14/2017

VAERS ID: 30060 Before After
VAERS Form:(blank) 1
Age:1.3
Sex:Male
Location:Minnesota
Vaccinated:1991-03-26
Onset:1991-03-27
Submitted:1991-04-18
Entered:1991-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH M685EN / - UNK RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1929S / - UNK LL / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion, Diarrhoea, Muscle twitching, Stupor, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Normal EEG, Normal CT SCAN, Normal Blood work, Lytes, CA Gluc, Mg
CDC 'Split Type':

Write-up: 4hrs post vax developed v, d 6x each between 6PM & 7AM; no fever, febrile sz, arched back legs stiff no clonus, eye dilated & "empty look", ? lt cheek & lt arm twitching;


Changed on 2/14/2018

VAERS ID: 30060 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:Minnesota
Vaccinated:1991-03-26
Onset:1991-03-27
Submitted:1991-04-18
Entered:1991-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH M685EN / UNK RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1929S / UNK LL / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion, Diarrhoea, Muscle twitching, Stupor, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Normal EEG, Normal CT SCAN, Normal Blood work, Lytes, CA Gluc, Mg
CDC 'Split Type':

Write-up: 4hrs post vax developed v, d 6x each between 6PM & 7AM; no fever, febrile sz, arched back legs stiff no clonus, eye dilated & "empty look", ? lt cheek & lt arm twitching;


Changed on 6/14/2018

VAERS ID: 30060 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:Minnesota
Vaccinated:1991-03-26
Onset:1991-03-27
Submitted:1991-04-18
Entered:1991-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH M685EN / UNK RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1929S / UNK LL / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion, Diarrhoea, Muscle twitching, Stupor, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Normal EEG, Normal CT SCAN, Normal Blood work, Lytes, CA Gluc, Mg
CDC 'Split Type':

Write-up: 4hrs post vax developed v, d 6x each between 6PM & 7AM; no fever, febrile sz, arched back legs stiff no clonus, eye dilated & "empty look", ? lt cheek & lt arm twitching;


Changed on 8/14/2018

VAERS ID: 30060 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:Minnesota
Vaccinated:1991-03-26
Onset:1991-03-27
Submitted:1991-04-18
Entered:1991-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH M685EN / UNK RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1929S / UNK LL / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion, Diarrhoea, Muscle twitching, Stupor, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Normal EEG, Normal CT SCAN, Normal Blood work, Lytes, CA Gluc, Mg
CDC 'Split Type':

Write-up: 4hrs post vax developed v, d 6x each between 6PM & 7AM; no fever, febrile sz, arched back legs stiff no clonus, eye dilated & "empty look", ? lt cheek & lt arm twitching;


Changed on 9/14/2018

VAERS ID: 30060 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:Minnesota
Vaccinated:1991-03-26
Onset:1991-03-27
Submitted:1991-04-18
Entered:1991-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH M685EN / UNK RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1929S / UNK LL / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion, Diarrhoea, Muscle twitching, Stupor, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Normal EEG, Normal CT SCAN, Normal Blood work, Lytes, CA Gluc, Mg
CDC 'Split Type':

Write-up: 4hrs post vax developed v, d 6x each between 6PM & 7AM; no fever, febrile sz, arched back legs stiff no clonus, eye dilated & "empty look", ? lt cheek & lt arm twitching;


Changed on 10/14/2018

VAERS ID: 30060 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:Minnesota
Vaccinated:1991-03-26
Onset:1991-03-27
Submitted:1991-04-18
Entered:1991-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH M685EN / UNK RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1929S / UNK LL / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion, Diarrhoea, Muscle twitching, Stupor, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Normal EEG, Normal CT SCAN, Normal Blood work, Lytes, CA Gluc, Mg
CDC 'Split Type':

Write-up: 4hrs post vax developed v, d 6x each between 6PM & 7AM; no fever, febrile sz, arched back legs stiff no clonus, eye dilated & "empty look", ? lt cheek & lt arm twitching;

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