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This is VAERS ID 37479

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 37479
VAERS Form:
Age:1.3
Sex:Female
Location:Michigan
Vaccinated:1991-08-22
Onset:1991-08-22
Submitted:0000-00-00
Entered:1992-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II / MSD 0977T / 0 - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: CONVULS, FEVER, RASH, LAB TEST ABNORM, CSF ABNORM

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 25AUG91 WBC Count-7100; Segemented neutrophils-21; BANDS-53; Serum glucose-75; Protein-17; Serum Magnesium-2.4; Serum calcium-9.1; LP-3WBC/HPF;
CDC 'Split Type':

Write-up: pt recvd MMR vax on 22AUG91 & 36 hrs following vax pt devel a rash & fever; also vomited once; 25AUG91 presented to ER w/tonoclonic seizure; t104.4 ax & pt was hospitalized;


Changed on 12/8/2009

VAERS ID: 37479 Before After
VAERS Form:
Age:1.3
Sex:Female
Location:Michigan
Vaccinated:1991-08-22
Onset:1991-08-22
Submitted:0000-00-00
Entered:1992-08-03 1992-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 0977T / 0 - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Convulsion, Laboratory test abnormal, Pyrexia, Rash, Vomiting, CSF test abnormal, CONVULS, FEVER, RASH, LAB TEST ABNORM, CSF ABNORM

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 25AUG91 WBC Count-7100; Segemented neutrophils-21; BANDS-53; Serum glucose-75; Protein-17; Serum Magnesium-2.4; Serum calcium-9.1; LP-3WBC/HPF;
CDC 'Split Type': (blank) WAES91090001

Write-up: pt recvd MMR vax on 22AUG91 & 36 hrs following vax pt devel a rash & fever; also vomited once; 25AUG91 presented to ER w/tonoclonic seizure; t104.4 ax & pt was hospitalized;


Changed on 5/14/2017

VAERS ID: 37479 Before After
VAERS Form:
Age:1.3
Sex:Female
Location:Michigan
Vaccinated:1991-08-22
Onset:1991-08-22
Submitted:0000-00-00
Entered:1992-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0977T / 0 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Convulsion, Laboratory test abnormal, Pyrexia, Rash, Vomiting, CSF test abnormal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 25AUG91 WBC Count-7100; Segemented neutrophils-21; BANDS-53; Serum glucose-75; Protein-17; Serum Magnesium-2.4; Serum calcium-9.1; LP-3WBC/HPF;
CDC 'Split Type': WAES91090001

Write-up: pt recvd MMR vax on 22AUG91 & 36 hrs following vax pt devel a rash & fever; also vomited once; 25AUG91 presented to ER w/tonoclonic seizure; t104.4 ax & pt was hospitalized;


Changed on 9/14/2017

VAERS ID: 37479 Before After
VAERS Form:(blank) 1
Age:1.3
Sex:Female
Location:Michigan
Vaccinated:1991-08-22
Onset:1991-08-22
Submitted:0000-00-00
Entered:1992-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0977T / 0 1 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Convulsion, Laboratory test abnormal, Pyrexia, Rash, Vomiting, CSF test abnormal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 25AUG91 WBC Count-7100; Segemented neutrophils-21; BANDS-53; Serum glucose-75; Protein-17; Serum Magnesium-2.4; Serum calcium-9.1; LP-3WBC/HPF;
CDC 'Split Type': WAES91090001

Write-up: pt recvd MMR vax on 22AUG91 & 36 hrs following vax pt devel a rash & fever; also vomited once; 25AUG91 presented to ER w/tonoclonic seizure; t104.4 ax & pt was hospitalized;


Changed on 2/14/2018

VAERS ID: 37479 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Michigan
Vaccinated:1991-08-22
Onset:1991-08-22
Submitted:0000-00-00
Entered:1992-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0977T / 1 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Convulsion, Laboratory test abnormal, Pyrexia, Rash, Vomiting, CSF test abnormal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 25AUG91 WBC Count-7100; Segemented neutrophils-21; BANDS-53; Serum glucose-75; Protein-17; Serum Magnesium-2.4; Serum calcium-9.1; LP-3WBC/HPF;
CDC 'Split Type': WAES91090001

Write-up: pt recvd MMR vax on 22AUG91 & 36 hrs following vax pt devel a rash & fever; also vomited once; 25AUG91 presented to ER w/tonoclonic seizure; t104.4 ax & pt was hospitalized;


Changed on 6/14/2018

VAERS ID: 37479 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Michigan
Vaccinated:1991-08-22
Onset:1991-08-22
Submitted:0000-00-00
Entered:1992-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0977T / 1 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Convulsion, Laboratory test abnormal, Pyrexia, Rash, Vomiting, CSF test abnormal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 25AUG91 WBC Count-7100; Segemented neutrophils-21; BANDS-53; Serum glucose-75; Protein-17; Serum Magnesium-2.4; Serum calcium-9.1; LP-3WBC/HPF;
CDC 'Split Type': WAES91090001

Write-up: pt recvd MMR vax on 22AUG91 & 36 hrs following vax pt devel a rash & fever; also vomited once; 25AUG91 presented to ER w/tonoclonic seizure; t104.4 ax & pt was hospitalized;


Changed on 8/14/2018

VAERS ID: 37479 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Michigan
Vaccinated:1991-08-22
Onset:1991-08-22
Submitted:0000-00-00
Entered:1992-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0977T / 1 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Convulsion, Laboratory test abnormal, Pyrexia, Rash, Vomiting, CSF test abnormal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 25AUG91 WBC Count-7100; Segemented neutrophils-21; BANDS-53; Serum glucose-75; Protein-17; Serum Magnesium-2.4; Serum calcium-9.1; LP-3WBC/HPF;
CDC 'Split Type': WAES91090001

Write-up: pt recvd MMR vax on 22AUG91 & 36 hrs following vax pt devel a rash & fever; also vomited once; 25AUG91 presented to ER w/tonoclonic seizure; t104.4 ax & pt was hospitalized;


Changed on 9/14/2018

VAERS ID: 37479 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Michigan
Vaccinated:1991-08-22
Onset:1991-08-22
Submitted:0000-00-00
Entered:1992-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0977T / 1 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Convulsion, Laboratory test abnormal, Pyrexia, Rash, Vomiting, CSF test abnormal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 25AUG91 WBC Count-7100; Segemented neutrophils-21; BANDS-53; Serum glucose-75; Protein-17; Serum Magnesium-2.4; Serum calcium-9.1; LP-3WBC/HPF;
CDC 'Split Type': WAES91090001

Write-up: pt recvd MMR vax on 22AUG91 & 36 hrs following vax pt devel a rash & fever; also vomited once; 25AUG91 presented to ER w/tonoclonic seizure; t104.4 ax & pt was hospitalized;


Changed on 10/14/2018

VAERS ID: 37479 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Michigan
Vaccinated:1991-08-22
Onset:1991-08-22
Submitted:0000-00-00
Entered:1992-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0977T / 1 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Convulsion, Laboratory test abnormal, Pyrexia, Rash, Vomiting, CSF test abnormal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 25AUG91 WBC Count-7100; Segemented neutrophils-21; BANDS-53; Serum glucose-75; Protein-17; Serum Magnesium-2.4; Serum calcium-9.1; LP-3WBC/HPF;
CDC 'Split Type': WAES91090001

Write-up: pt recvd MMR vax on 22AUG91 & 36 hrs following vax pt devel a rash & fever; also vomited once; 25AUG91 presented to ER w/tonoclonic seizure; t104.4 ax & pt was hospitalized;

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=37479&WAYBACKHISTORY=ON


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