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This is VAERS ID 33018

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 33018
VAERS Form:
Age:1.6
Sex:Female
Location:Pennsylvania
Vaccinated:1990-05-22
Onset:1990-05-23
Submitted:0000-00-00
Entered:1991-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: UNK. DTP / UNCLASSIFIED - / 3 - / -
MMR: MMR II / MSD 0489S / 0 RA / SC
OPV: UNK. POLIOVIRUS LIVE ORAL TRIVALENT / UNCLASSIFIED - / 2 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: HYPOKINESIA, COORDINAT ABNORM, ATAXIA, HEM, ANOMALY VASCUL

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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: X-ray - soft tissue mass.
CDC 'Split Type':

Write-up: 22May90 pt vax; devel firm, sore, tender, egglike mass in triceps area. 24May90 xray revealed the mass to be soft tissue density arising from triceps muscle mass. One week later pt was fussy & more clumsy than usual. See worm..


Changed on 12/8/2009

VAERS ID: 33018 Before After
VAERS Form:
Age:1.6
Sex:Female
Location:Pennsylvania
Vaccinated:1990-05-22
Onset:1990-05-23
Submitted:0000-00-00
Entered:1991-07-30 1991-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: UNK. DTP DTP (NO BRAND NAME) / UNCLASSIFIED UNKNOWN MANUFACTURER - / 3 - / -
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 0489S / 0 RA / SC
OPV: UNK. POLIOVIRUS LIVE ORAL TRIVALENT POLIO VIRUS, ORAL (NO BRAND NAME) / UNCLASSIFIED UNKNOWN MANUFACTURER - / 2 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Coordination abnormal, Hypokinesia, Injection site mass, Injection site pain, Subcutaneous nodule, Vascular anomaly, Haemorrhage, HYPOKINESIA, COORDINAT ABNORM, ATAXIA, HEM, ANOMALY VASCUL

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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: X-ray - soft tissue mass.
CDC 'Split Type': (blank) WAES90051200

Write-up: 22May90 pt vax; devel firm, sore, tender, egglike mass in triceps area. 24May90 xray revealed the mass to be soft tissue density arising from triceps muscle mass. One week later pt was fussy & more clumsy than usual. See worm..


Changed on 5/14/2017

VAERS ID: 33018 Before After
VAERS Form:
Age:1.6
Sex:Female
Location:Pennsylvania
Vaccinated:1990-05-22
Onset:1990-05-23
Submitted:0000-00-00
Entered:1991-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 3 - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0489S / 0 RA / SC
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Coordination abnormal, Hypokinesia, Injection site mass, Injection site pain, Subcutaneous nodule, Vascular anomaly, Haemorrhage

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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: None
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: X-ray - soft tissue mass.
CDC 'Split Type': WAES90051200

Write-up: 22May90 pt vax; devel firm, sore, tender, egglike mass in triceps area. 24May90 xray revealed the mass to be soft tissue density arising from triceps muscle mass. One week later pt was fussy & more clumsy than usual. See worm..


Changed on 9/14/2017

VAERS ID: 33018 Before After
VAERS Form:(blank) 1
Age:1.6
Sex:Female
Location:Pennsylvania
Vaccinated:1990-05-22
Onset:1990-05-23
Submitted:0000-00-00
Entered:1991-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 3 4 - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0489S / 0 1 RA / SC
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 3 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Coordination abnormal, Hypokinesia, Injection site mass, Injection site pain, Subcutaneous nodule, Vascular anomaly, Haemorrhage

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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: None
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: X-ray - soft tissue mass.
CDC 'Split Type': WAES90051200

Write-up: 22May90 pt vax; devel firm, sore, tender, egglike mass in triceps area. 24May90 xray revealed the mass to be soft tissue density arising from triceps muscle mass. One week later pt was fussy & more clumsy than usual. See worm..


Changed on 2/14/2018

VAERS ID: 33018 Before After
VAERS Form:1
Age:1.6
Sex:Female
Location:Pennsylvania
Vaccinated:1990-05-22
Onset:1990-05-23
Submitted:0000-00-00
Entered:1991-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 4 - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0489S / 1 RA / SC
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 3 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Coordination abnormal, Hypokinesia, Injection site mass, Injection site pain, Subcutaneous nodule, Vascular anomaly, Haemorrhage

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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: None
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: X-ray - soft tissue mass.
CDC 'Split Type': WAES90051200

Write-up: 22May90 pt vax; devel firm, sore, tender, egglike mass in triceps area. 24May90 xray revealed the mass to be soft tissue density arising from triceps muscle mass. One week later pt was fussy & more clumsy than usual. See worm..


Changed on 6/14/2018

VAERS ID: 33018 Before After
VAERS Form:1
Age:1.6
Sex:Female
Location:Pennsylvania
Vaccinated:1990-05-22
Onset:1990-05-23
Submitted:0000-00-00
Entered:1991-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 4 - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0489S / 1 RA / SC
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 3 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Coordination abnormal, Hypokinesia, Injection site mass, Injection site pain, Subcutaneous nodule, Vascular anomaly, Haemorrhage

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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: None
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: X-ray - soft tissue mass.
CDC 'Split Type': WAES90051200

Write-up: 22May90 pt vax; devel firm, sore, tender, egglike mass in triceps area. 24May90 xray revealed the mass to be soft tissue density arising from triceps muscle mass. One week later pt was fussy & more clumsy than usual. See worm..


Changed on 8/14/2018

VAERS ID: 33018 Before After
VAERS Form:1
Age:1.6
Sex:Female
Location:Pennsylvania
Vaccinated:1990-05-22
Onset:1990-05-23
Submitted:0000-00-00
Entered:1991-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 4 - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0489S / 1 RA / SC
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 3 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Coordination abnormal, Hypokinesia, Injection site mass, Injection site pain, Subcutaneous nodule, Vascular anomaly, Haemorrhage

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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: None
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: X-ray - soft tissue mass.
CDC 'Split Type': WAES90051200

Write-up: 22May90 pt vax; devel firm, sore, tender, egglike mass in triceps area. 24May90 xray revealed the mass to be soft tissue density arising from triceps muscle mass. One week later pt was fussy & more clumsy than usual. See worm..


Changed on 9/14/2018

VAERS ID: 33018 Before After
VAERS Form:1
Age:1.6
Sex:Female
Location:Pennsylvania
Vaccinated:1990-05-22
Onset:1990-05-23
Submitted:0000-00-00
Entered:1991-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 4 - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0489S / 1 RA / SC
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 3 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Coordination abnormal, Hypokinesia, Injection site mass, Injection site pain, Subcutaneous nodule, Vascular anomaly, Haemorrhage

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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: None
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: X-ray - soft tissue mass.
CDC 'Split Type': WAES90051200

Write-up: 22May90 pt vax; devel firm, sore, tender, egglike mass in triceps area. 24May90 xray revealed the mass to be soft tissue density arising from triceps muscle mass. One week later pt was fussy & more clumsy than usual. See worm..


Changed on 10/14/2018

VAERS ID: 33018 Before After
VAERS Form:1
Age:1.6
Sex:Female
Location:Pennsylvania
Vaccinated:1990-05-22
Onset:1990-05-23
Submitted:0000-00-00
Entered:1991-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 4 - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0489S / 1 RA / SC
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 3 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Coordination abnormal, Hypokinesia, Injection site mass, Injection site pain, Subcutaneous nodule, Vascular anomaly, Haemorrhage

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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: None
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: X-ray - soft tissue mass.
CDC 'Split Type': WAES90051200

Write-up: 22May90 pt vax; devel firm, sore, tender, egglike mass in triceps area. 24May90 xray revealed the mass to be soft tissue density arising from triceps muscle mass. One week later pt was fussy & more clumsy than usual. See worm..

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