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This is VAERS ID 33004

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 33004
VAERS Form:
Age:1.3
Sex:Male
Location:New Jersey
Vaccinated:1990-04-12
Onset:1990-04-26
Submitted:0000-00-00
Entered:1991-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II / MSD 2260R / 0 - / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: CONVULS, ENCEPHALITIS, CSF ABNORM, FEBRILE SEIZURE, BABINSKI SIGN POS

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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: Hx of asthma
Allergies:
Diagnostic Lab Data: WBC - 4/26, 13.4; Hemoglobin - 4/26, 9.3; Hematocrit - 4/26, 28.9;Neutrophils - 4/26, 16%; Bands - 4/26, 1%; Lymphocites - 70%; ESR - 4/26 - 7; WBC - 4/27, 11.4; Neutrophils - 4/27, 36%; Bands - 4/27, 4%; See worm...
CDC 'Split Type':

Write-up: 12Apr90 pt vax; 26apr90 devel fever, focal rt sided seizures for 25-30 minutes. Tx w/ Valium and admitted to ER. MD felt that seizures due to viral infection or vax. Tx w/ Ferusal for iron deficiency anemia. See worm...


Changed on 12/8/2009

VAERS ID: 33004 Before After
VAERS Form:
Age:1.3
Sex:Male
Location:New Jersey
Vaccinated:1990-04-12
Onset:1990-04-26
Submitted:0000-00-00
Entered:1991-07-30 1991-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 2260R / 0 - / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Convulsion, Encephalitis, Extensor plantar response, Febrile convulsion, Hemiplegia, Infection, Stupor, CSF test abnormal, CONVULS, ENCEPHALITIS, CSF ABNORM, FEBRILE SEIZURE, BABINSKI SIGN POS

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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: Hx of asthma
Allergies:
Diagnostic Lab Data: WBC - 4/26, 13.4; Hemoglobin - 4/26, 9.3; Hematocrit - 4/26, 28.9;Neutrophils - 4/26, 16%; Bands - 4/26, 1%; Lymphocites - 70%; ESR - 4/26 - 7; WBC - 4/27, 11.4; Neutrophils - 4/27, 36%; Bands - 4/27, 4%; See worm...
CDC 'Split Type': (blank) WAES90050250

Write-up: 12Apr90 pt vax; 26apr90 devel fever, focal rt sided seizures for 25-30 minutes. Tx w/ Valium and admitted to ER. MD felt that seizures due to viral infection or vax. Tx w/ Ferusal for iron deficiency anemia. See worm...


Changed on 5/14/2017

VAERS ID: 33004 Before After
VAERS Form:
Age:1.3
Sex:Male
Location:New Jersey
Vaccinated:1990-04-12
Onset:1990-04-26
Submitted:0000-00-00
Entered:1991-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 2260R / 0 - / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Convulsion, Encephalitis, Extensor plantar response, Febrile convulsion, Hemiplegia, Infection, Stupor, CSF test abnormal

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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: None
Current Illness:
Preexisting Conditions: Hx of asthma
Allergies:
Diagnostic Lab Data: WBC - 4/26, 13.4; Hemoglobin - 4/26, 9.3; Hematocrit - 4/26, 28.9;Neutrophils - 4/26, 16%; Bands - 4/26, 1%; Lymphocites - 70%; ESR - 4/26 - 7; WBC - 4/27, 11.4; Neutrophils - 4/27, 36%; Bands - 4/27, 4%; See worm...
CDC 'Split Type': WAES90050250

Write-up: 12Apr90 pt vax; 26apr90 devel fever, focal rt sided seizures for 25-30 minutes. Tx w/ Valium and admitted to ER. MD felt that seizures due to viral infection or vax. Tx w/ Ferusal for iron deficiency anemia. See worm...


Changed on 9/14/2017

VAERS ID: 33004 Before After
VAERS Form:(blank) 1
Age:1.3
Sex:Male
Location:New Jersey
Vaccinated:1990-04-12
Onset:1990-04-26
Submitted:0000-00-00
Entered:1991-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 2260R / 0 1 - / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Convulsion, Encephalitis, Extensor plantar response, Febrile convulsion, Hemiplegia, Infection, Stupor, CSF test abnormal

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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: None
Current Illness:
Preexisting Conditions: Hx of asthma
Allergies:
Diagnostic Lab Data: WBC - 4/26, 13.4; Hemoglobin - 4/26, 9.3; Hematocrit - 4/26, 28.9;Neutrophils - 4/26, 16%; Bands - 4/26, 1%; Lymphocites - 70%; ESR - 4/26 - 7; WBC - 4/27, 11.4; Neutrophils - 4/27, 36%; Bands - 4/27, 4%; See worm...
CDC 'Split Type': WAES90050250

Write-up: 12Apr90 pt vax; 26apr90 devel fever, focal rt sided seizures for 25-30 minutes. Tx w/ Valium and admitted to ER. MD felt that seizures due to viral infection or vax. Tx w/ Ferusal for iron deficiency anemia. See worm...


Changed on 2/14/2018

VAERS ID: 33004 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:New Jersey
Vaccinated:1990-04-12
Onset:1990-04-26
Submitted:0000-00-00
Entered:1991-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 2260R / 1 - / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Convulsion, Encephalitis, Extensor plantar response, Febrile convulsion, Hemiplegia, Infection, Stupor, CSF test abnormal

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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: None
Current Illness:
Preexisting Conditions: Hx of asthma
Allergies:
Diagnostic Lab Data: WBC - 4/26, 13.4; Hemoglobin - 4/26, 9.3; Hematocrit - 4/26, 28.9;Neutrophils - 4/26, 16%; Bands - 4/26, 1%; Lymphocites - 70%; ESR - 4/26 - 7; WBC - 4/27, 11.4; Neutrophils - 4/27, 36%; Bands - 4/27, 4%; See worm...
CDC 'Split Type': WAES90050250

Write-up: 12Apr90 pt vax; 26apr90 devel fever, focal rt sided seizures for 25-30 minutes. Tx w/ Valium and admitted to ER. MD felt that seizures due to viral infection or vax. Tx w/ Ferusal for iron deficiency anemia. See worm...


Changed on 6/14/2018

VAERS ID: 33004 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:New Jersey
Vaccinated:1990-04-12
Onset:1990-04-26
Submitted:0000-00-00
Entered:1991-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 2260R / 1 - / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Convulsion, Encephalitis, Extensor plantar response, Febrile convulsion, Hemiplegia, Infection, Stupor, CSF test abnormal

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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: None
Current Illness:
Preexisting Conditions: Hx of asthma
Allergies:
Diagnostic Lab Data: WBC - 4/26, 13.4; Hemoglobin - 4/26, 9.3; Hematocrit - 4/26, 28.9;Neutrophils - 4/26, 16%; Bands - 4/26, 1%; Lymphocites - 70%; ESR - 4/26 - 7; WBC - 4/27, 11.4; Neutrophils - 4/27, 36%; Bands - 4/27, 4%; See worm...
CDC 'Split Type': WAES90050250

Write-up: 12Apr90 pt vax; 26apr90 devel fever, focal rt sided seizures for 25-30 minutes. Tx w/ Valium and admitted to ER. MD felt that seizures due to viral infection or vax. Tx w/ Ferusal for iron deficiency anemia. See worm...


Changed on 8/14/2018

VAERS ID: 33004 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:New Jersey
Vaccinated:1990-04-12
Onset:1990-04-26
Submitted:0000-00-00
Entered:1991-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 2260R / 1 - / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Convulsion, Encephalitis, Extensor plantar response, Febrile convulsion, Hemiplegia, Infection, Stupor, CSF test abnormal

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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: None
Current Illness:
Preexisting Conditions: Hx of asthma
Allergies:
Diagnostic Lab Data: WBC - 4/26, 13.4; Hemoglobin - 4/26, 9.3; Hematocrit - 4/26, 28.9;Neutrophils - 4/26, 16%; Bands - 4/26, 1%; Lymphocites - 70%; ESR - 4/26 - 7; WBC - 4/27, 11.4; Neutrophils - 4/27, 36%; Bands - 4/27, 4%; See worm...
CDC 'Split Type': WAES90050250

Write-up: 12Apr90 pt vax; 26apr90 devel fever, focal rt sided seizures for 25-30 minutes. Tx w/ Valium and admitted to ER. MD felt that seizures due to viral infection or vax. Tx w/ Ferusal for iron deficiency anemia. See worm...


Changed on 9/14/2018

VAERS ID: 33004 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:New Jersey
Vaccinated:1990-04-12
Onset:1990-04-26
Submitted:0000-00-00
Entered:1991-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 2260R / 1 - / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Convulsion, Encephalitis, Extensor plantar response, Febrile convulsion, Hemiplegia, Infection, Stupor, CSF test abnormal

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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: None
Current Illness:
Preexisting Conditions: Hx of asthma
Allergies:
Diagnostic Lab Data: WBC - 4/26, 13.4; Hemoglobin - 4/26, 9.3; Hematocrit - 4/26, 28.9;Neutrophils - 4/26, 16%; Bands - 4/26, 1%; Lymphocites - 70%; ESR - 4/26 - 7; WBC - 4/27, 11.4; Neutrophils - 4/27, 36%; Bands - 4/27, 4%; See worm...
CDC 'Split Type': WAES90050250

Write-up: 12Apr90 pt vax; 26apr90 devel fever, focal rt sided seizures for 25-30 minutes. Tx w/ Valium and admitted to ER. MD felt that seizures due to viral infection or vax. Tx w/ Ferusal for iron deficiency anemia. See worm...


Changed on 10/14/2018

VAERS ID: 33004 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:New Jersey
Vaccinated:1990-04-12
Onset:1990-04-26
Submitted:0000-00-00
Entered:1991-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 2260R / 1 - / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Convulsion, Encephalitis, Extensor plantar response, Febrile convulsion, Hemiplegia, Infection, Stupor, CSF test abnormal

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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: None
Current Illness:
Preexisting Conditions: Hx of asthma
Allergies:
Diagnostic Lab Data: WBC - 4/26, 13.4; Hemoglobin - 4/26, 9.3; Hematocrit - 4/26, 28.9;Neutrophils - 4/26, 16%; Bands - 4/26, 1%; Lymphocites - 70%; ESR - 4/26 - 7; WBC - 4/27, 11.4; Neutrophils - 4/27, 36%; Bands - 4/27, 4%; See worm...
CDC 'Split Type': WAES90050250

Write-up: 12Apr90 pt vax; 26apr90 devel fever, focal rt sided seizures for 25-30 minutes. Tx w/ Valium and admitted to ER. MD felt that seizures due to viral infection or vax. Tx w/ Ferusal for iron deficiency anemia. See worm...

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