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This is VAERS ID 33517

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 33517
VAERS Form:
Age:1.3
Sex:Female
Location:Washington
Vaccinated:1990-10-11
Onset:1990-10-13
Submitted:0000-00-00
Entered:1991-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: UNK. DTP / UNCLASSIFIED - / - - / -
MMR: MMR II / MSD 1715S / - - / -
OPV: UNK. POLIOVIRUS LIVE ORAL TRIVALENT / UNCLASSIFIED - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: AGITATION, CONVULS

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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: OM
Preexisting Conditions: No relevant hx
Allergies:
Diagnostic Lab Data: 15OCT90 LP-clear fluid
CDC 'Split Type':

Write-up: Pt recvd MMR/DTP/OPV vax 11OCT90; On 13OCT90 pt was very irritable intermittently; On 15OCT90 exp poss sz versus breath holding; Hospitalized to r/o paritally treated meningitis; LP revealed clear fluid;


Changed on 12/8/2009

VAERS ID: 33517 Before After
VAERS Form:
Age:1.3
Sex:Female
Location:Washington
Vaccinated:1990-10-11
Onset:1990-10-13
Submitted:0000-00-00
Entered:1991-08-13 1991-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: UNK. DTP DTP (NO BRAND NAME) / UNCLASSIFIED UNKNOWN MANUFACTURER - / - - / -
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 1715S / - - / -
OPV: UNK. POLIOVIRUS LIVE ORAL TRIVALENT POLIO VIRUS, ORAL (NO BRAND NAME) / UNCLASSIFIED UNKNOWN MANUFACTURER - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Agitation, Convulsion, AGITATION, CONVULS

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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: OM
Preexisting Conditions: No relevant hx
Allergies:
Diagnostic Lab Data: 15OCT90 LP-clear fluid
CDC 'Split Type': (blank) WAES90101019

Write-up: Pt recvd MMR/DTP/OPV vax 11OCT90; On 13OCT90 pt was very irritable intermittently; On 15OCT90 exp poss sz versus breath holding; Hospitalized to r/o paritally treated meningitis; LP revealed clear fluid;


Changed on 5/14/2017

VAERS ID: 33517 Before After
VAERS Form:
Age:1.3
Sex:Female
Location:Washington
Vaccinated:1990-10-11
Onset:1990-10-13
Submitted:0000-00-00
Entered:1991-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1715S / - - / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Agitation, Convulsion

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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: OM
Preexisting Conditions: No relevant hx
Allergies:
Diagnostic Lab Data: 15OCT90 LP-clear fluid
CDC 'Split Type': WAES90101019

Write-up: Pt recvd MMR/DTP/OPV vax 11OCT90; On 13OCT90 pt was very irritable intermittently; On 15OCT90 exp poss sz versus breath holding; Hospitalized to r/o paritally treated meningitis; LP revealed clear fluid;


Changed on 9/14/2017

VAERS ID: 33517 Before After
VAERS Form:(blank) 1
Age:1.3
Sex:Female
Location:Washington
Vaccinated:1990-10-11
Onset:1990-10-13
Submitted:0000-00-00
Entered:1991-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1715S / - UNK - / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Agitation, Convulsion

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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: OM
Preexisting Conditions: No relevant hx
Allergies:
Diagnostic Lab Data: 15OCT90 LP-clear fluid
CDC 'Split Type': WAES90101019

Write-up: Pt recvd MMR/DTP/OPV vax 11OCT90; On 13OCT90 pt was very irritable intermittently; On 15OCT90 exp poss sz versus breath holding; Hospitalized to r/o paritally treated meningitis; LP revealed clear fluid;


Changed on 2/14/2018

VAERS ID: 33517 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Washington
Vaccinated:1990-10-11
Onset:1990-10-13
Submitted:0000-00-00
Entered:1991-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1715S / UNK - / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Agitation, Convulsion

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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: OM
Preexisting Conditions: No relevant hx
Allergies:
Diagnostic Lab Data: 15OCT90 LP-clear fluid
CDC 'Split Type': WAES90101019

Write-up: Pt recvd MMR/DTP/OPV vax 11OCT90; On 13OCT90 pt was very irritable intermittently; On 15OCT90 exp poss sz versus breath holding; Hospitalized to r/o paritally treated meningitis; LP revealed clear fluid;


Changed on 6/14/2018

VAERS ID: 33517 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Washington
Vaccinated:1990-10-11
Onset:1990-10-13
Submitted:0000-00-00
Entered:1991-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1715S / UNK - / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Agitation, Convulsion

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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: OM
Preexisting Conditions: No relevant hx
Allergies:
Diagnostic Lab Data: 15OCT90 LP-clear fluid
CDC 'Split Type': WAES90101019

Write-up: Pt recvd MMR/DTP/OPV vax 11OCT90; On 13OCT90 pt was very irritable intermittently; On 15OCT90 exp poss sz versus breath holding; Hospitalized to r/o paritally treated meningitis; LP revealed clear fluid;


Changed on 8/14/2018

VAERS ID: 33517 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Washington
Vaccinated:1990-10-11
Onset:1990-10-13
Submitted:0000-00-00
Entered:1991-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1715S / UNK - / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Agitation, Convulsion

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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: OM
Preexisting Conditions: No relevant hx
Allergies:
Diagnostic Lab Data: 15OCT90 LP-clear fluid
CDC 'Split Type': WAES90101019

Write-up: Pt recvd MMR/DTP/OPV vax 11OCT90; On 13OCT90 pt was very irritable intermittently; On 15OCT90 exp poss sz versus breath holding; Hospitalized to r/o paritally treated meningitis; LP revealed clear fluid;


Changed on 9/14/2018

VAERS ID: 33517 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Washington
Vaccinated:1990-10-11
Onset:1990-10-13
Submitted:0000-00-00
Entered:1991-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1715S / UNK - / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Agitation, Convulsion

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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: OM
Preexisting Conditions: No relevant hx
Allergies:
Diagnostic Lab Data: 15OCT90 LP-clear fluid
CDC 'Split Type': WAES90101019

Write-up: Pt recvd MMR/DTP/OPV vax 11OCT90; On 13OCT90 pt was very irritable intermittently; On 15OCT90 exp poss sz versus breath holding; Hospitalized to r/o paritally treated meningitis; LP revealed clear fluid;


Changed on 10/14/2018

VAERS ID: 33517 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Washington
Vaccinated:1990-10-11
Onset:1990-10-13
Submitted:0000-00-00
Entered:1991-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1715S / UNK - / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Agitation, Convulsion

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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: OM
Preexisting Conditions: No relevant hx
Allergies:
Diagnostic Lab Data: 15OCT90 LP-clear fluid
CDC 'Split Type': WAES90101019

Write-up: Pt recvd MMR/DTP/OPV vax 11OCT90; On 13OCT90 pt was very irritable intermittently; On 15OCT90 exp poss sz versus breath holding; Hospitalized to r/o paritally treated meningitis; LP revealed clear fluid;

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=33517&WAYBACKHISTORY=ON


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