National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 31053

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 31053
VAERS Form:
Age:1.3
Sex:Female
Location:Kansas
Vaccinated:1991-02-27
Onset:1991-03-08
Submitted:1991-03-21
Entered:1991-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: PROHIBIT / CONNAUGHT LABS 0J11070 / 0 - / IM
MMR: MMR II / MSD 0555S / 0 - / SC

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

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: 3     Extended hospital stay? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: ?pt hospitalized
CDC 'Split Type': NONE

Write-up: Elevated fever, sz-2x; 103R dx OM point red rash ontorso started 8MAR91-hosp 8MAR91PM 11MAR91AM;


Changed on 12/8/2009

VAERS ID: 31053 Before After
VAERS Form:
Age:1.3
Sex:Female
Location:Kansas
Vaccinated:1991-02-27
Onset:1991-03-08
Submitted:1991-03-21
Entered:1991-06-10 1991-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: PROHIBIT HIB (PROHIBIT) / CONNAUGHT LABS CONNAUGHT LABORATORIES 0J11070 / 0 - / IM
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 0555S / 0 - / SC

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

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: 3     Extended hospital stay? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: ?pt hospitalized
CDC 'Split Type': NONE KS9112

Write-up: Elevated fever, sz-2x; 103R dx OM point red rash ontorso started 8MAR91-hosp 8MAR91PM 11MAR91AM;


Changed on 5/14/2017

VAERS ID: 31053 Before After
VAERS Form:
Age:1.3
Sex:Female
Location:Kansas
Vaccinated:1991-02-27
Onset:1991-03-08
Submitted:1991-03-21
Entered:1991-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0J11070 / 0 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0555S / 0 - / SC

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

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: 3     Extended hospital stay? No
Previous Vaccinations: NONE NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: ?pt hospitalized
CDC 'Split Type': KS9112

Write-up: Elevated fever, sz-2x; 103R dx OM point red rash ontorso started 8MAR91-hosp 8MAR91PM 11MAR91AM;


Changed on 9/14/2017

VAERS ID: 31053 Before After
VAERS Form:(blank) 1
Age:1.3
Sex:Female
Location:Kansas
Vaccinated:1991-02-27
Onset:1991-03-08
Submitted:1991-03-21
Entered:1991-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0J11070 / 0 1 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0555S / 0 1 - / SC

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

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: 3     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: ?pt hospitalized
CDC 'Split Type': KS9112

Write-up: Elevated fever, sz-2x; 103R dx OM point red rash ontorso started 8MAR91-hosp 8MAR91PM 11MAR91AM;


Changed on 2/14/2018

VAERS ID: 31053 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Kansas
Vaccinated:1991-02-27
Onset:1991-03-08
Submitted:1991-03-21
Entered:1991-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0J11070 / 1 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0555S / 1 - / SC

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

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: 3     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: ?pt hospitalized
CDC 'Split Type': KS9112

Write-up: Elevated fever, sz-2x; 103R dx OM point red rash ontorso started 8MAR91-hosp 8MAR91PM 11MAR91AM;


Changed on 6/14/2018

VAERS ID: 31053 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Kansas
Vaccinated:1991-02-27
Onset:1991-03-08
Submitted:1991-03-21
Entered:1991-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0J11070 / 1 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0555S / 1 - / SC

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

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: 3     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: ?pt hospitalized
CDC 'Split Type': KS9112

Write-up: Elevated fever, sz-2x; 103R dx OM point red rash ontorso started 8MAR91-hosp 8MAR91PM 11MAR91AM;


Changed on 8/14/2018

VAERS ID: 31053 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Kansas
Vaccinated:1991-02-27
Onset:1991-03-08
Submitted:1991-03-21
Entered:1991-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0J11070 / 1 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0555S / 1 - / SC

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

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: 3     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: ?pt hospitalized
CDC 'Split Type': KS9112

Write-up: Elevated fever, sz-2x; 103R dx OM point red rash ontorso started 8MAR91-hosp 8MAR91PM 11MAR91AM;


Changed on 9/14/2018

VAERS ID: 31053 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Kansas
Vaccinated:1991-02-27
Onset:1991-03-08
Submitted:1991-03-21
Entered:1991-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0J11070 / 1 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0555S / 1 - / SC

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

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: 3     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: ?pt hospitalized
CDC 'Split Type': KS9112

Write-up: Elevated fever, sz-2x; 103R dx OM point red rash ontorso started 8MAR91-hosp 8MAR91PM 11MAR91AM;


Changed on 10/14/2018

VAERS ID: 31053 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Kansas
Vaccinated:1991-02-27
Onset:1991-03-08
Submitted:1991-03-21
Entered:1991-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0J11070 / 1 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0555S / 1 - / SC

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

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: 3     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: ?pt hospitalized
CDC 'Split Type': KS9112

Write-up: Elevated fever, sz-2x; 103R dx OM point red rash ontorso started 8MAR91-hosp 8MAR91PM 11MAR91AM;

New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=31053&WAYBACKHISTORY=ON


Copyright © 2019 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166