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This is VAERS ID 31011

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 31011
VAERS Form:
Age:1.3
Sex:Male
Location:Florida
Vaccinated:1990-03-02
Onset:1990-03-12
Submitted:1991-05-10
Entered:1991-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II / MSD 1673R / 0 LL / -

Administered by: Private      Purchased by: Unknown
Symptoms: BRAIN SYND ACUTE, ESR INC, ENCEPHALOPATHY

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 14     Extended hospital stay? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: brain CT showed cortical atrophy 7 enlarged ventricles for age; ESR 85, CAT SCAN leukoencephalopathy; poss no true damage to myelin but only edema;
CDC 'Split Type': NONE

Write-up: 10 days post vax pt stopped walking, overnight; could not crawl, turn fr back to front or front to back, or hold up head; ESR ele @ 85, brain CT showed cortical atrophy & enlarged ventricles for age; Admitted to hosp; poss edema


Changed on 12/8/2009

VAERS ID: 31011 Before After
VAERS Form:
Age:1.3
Sex:Male
Location:Florida
Vaccinated:1990-03-02
Onset:1990-03-12
Submitted:1991-05-10
Entered:1991-06-07 1991-06-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 1673R / 0 LL / -

Administered by: Private      Purchased by: Unknown Other
Symptoms: Delirium, Encephalopathy, Red blood cell sedimentation rate increased, BRAIN SYND ACUTE, ESR INC, ENCEPHALOPATHY

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 14     Extended hospital stay? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: brain CT showed cortical atrophy 7 enlarged ventricles for age; ESR 85, CAT SCAN leukoencephalopathy; poss no true damage to myelin but only edema;
CDC 'Split Type': NONE (blank)

Write-up: 10 days post vax pt stopped walking, overnight; could not crawl, turn fr back to front or front to back, or hold up head; ESR ele @ 85, brain CT showed cortical atrophy & enlarged ventricles for age; Admitted to hosp; poss edema


Changed on 5/14/2017

VAERS ID: 31011 Before After
VAERS Form:
Age:1.3
Sex:Male
Location:Florida
Vaccinated:1990-03-02
Onset:1990-03-12
Submitted:1991-05-10
Entered:1991-06-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1673R / 0 LL / -

Administered by: Private      Purchased by: Other
Symptoms: Delirium, Encephalopathy, Red blood cell sedimentation rate increased

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 14     Extended hospital stay? No
Previous Vaccinations: NONE NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: brain CT showed cortical atrophy 7 enlarged ventricles for age; ESR 85, CAT SCAN leukoencephalopathy; poss no true damage to myelin but only edema;
CDC 'Split Type':

Write-up: 10 days post vax pt stopped walking, overnight; could not crawl, turn fr back to front or front to back, or hold up head; ESR ele @ 85, brain CT showed cortical atrophy & enlarged ventricles for age; Admitted to hosp; poss edema


Changed on 9/14/2017

VAERS ID: 31011 Before After
VAERS Form:(blank) 1
Age:1.3
Sex:Male
Location:Florida
Vaccinated:1990-03-02
Onset:1990-03-12
Submitted:1991-05-10
Entered:1991-06-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1673R / 0 1 LL / -

Administered by: Private      Purchased by: Other
Symptoms: Delirium, Encephalopathy, Red blood cell sedimentation rate increased

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 14     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: brain CT showed cortical atrophy 7 enlarged ventricles for age; ESR 85, CAT SCAN leukoencephalopathy; poss no true damage to myelin but only edema;
CDC 'Split Type':

Write-up: 10 days post vax pt stopped walking, overnight; could not crawl, turn fr back to front or front to back, or hold up head; ESR ele @ 85, brain CT showed cortical atrophy & enlarged ventricles for age; Admitted to hosp; poss edema


Changed on 2/14/2018

VAERS ID: 31011 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:Florida
Vaccinated:1990-03-02
Onset:1990-03-12
Submitted:1991-05-10
Entered:1991-06-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1673R / 1 LL / -

Administered by: Private      Purchased by: Other
Symptoms: Delirium, Encephalopathy, Red blood cell sedimentation rate increased

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 14     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: brain CT showed cortical atrophy 7 enlarged ventricles for age; ESR 85, CAT SCAN leukoencephalopathy; poss no true damage to myelin but only edema;
CDC 'Split Type':

Write-up: 10 days post vax pt stopped walking, overnight; could not crawl, turn fr back to front or front to back, or hold up head; ESR ele @ 85, brain CT showed cortical atrophy & enlarged ventricles for age; Admitted to hosp; poss edema


Changed on 6/14/2018

VAERS ID: 31011 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:Florida
Vaccinated:1990-03-02
Onset:1990-03-12
Submitted:1991-05-10
Entered:1991-06-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1673R / 1 LL / -

Administered by: Private      Purchased by: Other
Symptoms: Delirium, Encephalopathy, Red blood cell sedimentation rate increased

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 14     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: brain CT showed cortical atrophy 7 enlarged ventricles for age; ESR 85, CAT SCAN leukoencephalopathy; poss no true damage to myelin but only edema;
CDC 'Split Type':

Write-up: 10 days post vax pt stopped walking, overnight; could not crawl, turn fr back to front or front to back, or hold up head; ESR ele @ 85, brain CT showed cortical atrophy & enlarged ventricles for age; Admitted to hosp; poss edema


Changed on 8/14/2018

VAERS ID: 31011 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:Florida
Vaccinated:1990-03-02
Onset:1990-03-12
Submitted:1991-05-10
Entered:1991-06-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1673R / 1 LL / -

Administered by: Private      Purchased by: Other
Symptoms: Delirium, Encephalopathy, Red blood cell sedimentation rate increased

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 14     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: brain CT showed cortical atrophy 7 enlarged ventricles for age; ESR 85, CAT SCAN leukoencephalopathy; poss no true damage to myelin but only edema;
CDC 'Split Type':

Write-up: 10 days post vax pt stopped walking, overnight; could not crawl, turn fr back to front or front to back, or hold up head; ESR ele @ 85, brain CT showed cortical atrophy & enlarged ventricles for age; Admitted to hosp; poss edema


Changed on 9/14/2018

VAERS ID: 31011 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:Florida
Vaccinated:1990-03-02
Onset:1990-03-12
Submitted:1991-05-10
Entered:1991-06-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1673R / 1 LL / -

Administered by: Private      Purchased by: Other
Symptoms: Delirium, Encephalopathy, Red blood cell sedimentation rate increased

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 14     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: brain CT showed cortical atrophy 7 enlarged ventricles for age; ESR 85, CAT SCAN leukoencephalopathy; poss no true damage to myelin but only edema;
CDC 'Split Type':

Write-up: 10 days post vax pt stopped walking, overnight; could not crawl, turn fr back to front or front to back, or hold up head; ESR ele @ 85, brain CT showed cortical atrophy & enlarged ventricles for age; Admitted to hosp; poss edema


Changed on 10/14/2018

VAERS ID: 31011 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:Florida
Vaccinated:1990-03-02
Onset:1990-03-12
Submitted:1991-05-10
Entered:1991-06-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1673R / 1 LL / -

Administered by: Private      Purchased by: Other
Symptoms: Delirium, Encephalopathy, Red blood cell sedimentation rate increased

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 14     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: brain CT showed cortical atrophy 7 enlarged ventricles for age; ESR 85, CAT SCAN leukoencephalopathy; poss no true damage to myelin but only edema;
CDC 'Split Type':

Write-up: 10 days post vax pt stopped walking, overnight; could not crawl, turn fr back to front or front to back, or hold up head; ESR ele @ 85, brain CT showed cortical atrophy & enlarged ventricles for age; Admitted to hosp; poss edema

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