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This is VAERS ID 37279

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 37279
VAERS Form:
Age:1.1
Sex:Male
Location:New Jersey
Vaccinated:1991-05-09
Onset:1991-05-09
Submitted:0000-00-00
Entered:1992-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II / MSD 0763T / 0 - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: CONVULS, FEVER

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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: No relevant data;
CDC 'Split Type':

Write-up: Pt recvd MMR vax 9MAY91 & approx 1 hr following pt devel sz w/a fever; pt was hospitalized for sepsis work-up & was discharged as well 24 hrs later; no further details were provided;


Changed on 12/8/2009

VAERS ID: 37279 Before After
VAERS Form:
Age:1.1
Sex:Male
Location:New Jersey
Vaccinated:1991-05-09
Onset:1991-05-09
Submitted:0000-00-00
Entered:1992-07-21 1992-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 0763T / 0 - / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Convulsion, Pyrexia, CONVULS, FEVER

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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: No relevant data;
CDC 'Split Type': (blank) WAES91050941

Write-up: Pt recvd MMR vax 9MAY91 & approx 1 hr following pt devel sz w/a fever; pt was hospitalized for sepsis work-up & was discharged as well 24 hrs later; no further details were provided;


Changed on 5/14/2017

VAERS ID: 37279 Before After
VAERS Form:
Age:1.1
Sex:Male
Location:New Jersey
Vaccinated:1991-05-09
Onset:1991-05-09
Submitted:0000-00-00
Entered:1992-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0763T / 0 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Convulsion, 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: 1     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: No relevant data;
CDC 'Split Type': WAES91050941

Write-up: Pt recvd MMR vax 9MAY91 & approx 1 hr following pt devel sz w/a fever; pt was hospitalized for sepsis work-up & was discharged as well 24 hrs later; no further details were provided;


Changed on 9/14/2017

VAERS ID: 37279 Before After
VAERS Form:(blank) 1
Age:1.1
Sex:Male
Location:New Jersey
Vaccinated:1991-05-09
Onset:1991-05-09
Submitted:0000-00-00
Entered:1992-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0763T / 0 1 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Convulsion, 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: 1     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: No relevant data;
CDC 'Split Type': WAES91050941

Write-up: Pt recvd MMR vax 9MAY91 & approx 1 hr following pt devel sz w/a fever; pt was hospitalized for sepsis work-up & was discharged as well 24 hrs later; no further details were provided;


Changed on 2/14/2018

VAERS ID: 37279 Before After
VAERS Form:1
Age:1.1
Sex:Male
Location:New Jersey
Vaccinated:1991-05-09
Onset:1991-05-09
Submitted:0000-00-00
Entered:1992-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0763T / 1 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Convulsion, 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: 1     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: No relevant data;
CDC 'Split Type': WAES91050941

Write-up: Pt recvd MMR vax 9MAY91 & approx 1 hr following pt devel sz w/a fever; pt was hospitalized for sepsis work-up & was discharged as well 24 hrs later; no further details were provided;


Changed on 6/14/2018

VAERS ID: 37279 Before After
VAERS Form:1
Age:1.1
Sex:Male
Location:New Jersey
Vaccinated:1991-05-09
Onset:1991-05-09
Submitted:0000-00-00
Entered:1992-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0763T / 1 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Convulsion, 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: 1     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: No relevant data;
CDC 'Split Type': WAES91050941

Write-up: Pt recvd MMR vax 9MAY91 & approx 1 hr following pt devel sz w/a fever; pt was hospitalized for sepsis work-up & was discharged as well 24 hrs later; no further details were provided;


Changed on 8/14/2018

VAERS ID: 37279 Before After
VAERS Form:1
Age:1.1
Sex:Male
Location:New Jersey
Vaccinated:1991-05-09
Onset:1991-05-09
Submitted:0000-00-00
Entered:1992-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0763T / 1 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Convulsion, 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: 1     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: No relevant data;
CDC 'Split Type': WAES91050941

Write-up: Pt recvd MMR vax 9MAY91 & approx 1 hr following pt devel sz w/a fever; pt was hospitalized for sepsis work-up & was discharged as well 24 hrs later; no further details were provided;


Changed on 9/14/2018

VAERS ID: 37279 Before After
VAERS Form:1
Age:1.1
Sex:Male
Location:New Jersey
Vaccinated:1991-05-09
Onset:1991-05-09
Submitted:0000-00-00
Entered:1992-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0763T / 1 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Convulsion, 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: 1     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: No relevant data;
CDC 'Split Type': WAES91050941

Write-up: Pt recvd MMR vax 9MAY91 & approx 1 hr following pt devel sz w/a fever; pt was hospitalized for sepsis work-up & was discharged as well 24 hrs later; no further details were provided;


Changed on 10/14/2018

VAERS ID: 37279 Before After
VAERS Form:1
Age:1.1
Sex:Male
Location:New Jersey
Vaccinated:1991-05-09
Onset:1991-05-09
Submitted:0000-00-00
Entered:1992-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0763T / 1 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Convulsion, 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: 1     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: No relevant data;
CDC 'Split Type': WAES91050941

Write-up: Pt recvd MMR vax 9MAY91 & approx 1 hr following pt devel sz w/a fever; pt was hospitalized for sepsis work-up & was discharged as well 24 hrs later; no further details were provided;

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