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This is VAERS ID 43115

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 43115
VAERS Form:
Age:1.0
Sex:Female
Location:California
Vaccinated:1992-05-12
Onset:1992-05-14
Submitted:1992-06-16
Entered:1992-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II / MSD 0119V / 0 LL / IM

Administered by: Private      Purchased by: Unknown
Symptoms: AGITATION, BRAIN SYND ACUTE, FEVER, ATAXIA

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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: TB tine test
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: head CT neg; CSF neg;
CDC 'Split Type':

Write-up: pt recvd MMR vax 12MAY92 & onset of fever & fussiness; became inc fussy w/persistent crying; devel ataxia 3 days p/vax; had CT Scan, LP hospitalized for observation; pt neuro consult dx MMR rxn w/poss cerebellitis;


Changed on 12/8/2009

VAERS ID: 43115 Before After
VAERS Form:
Age:1.0
Sex:Female
Location:California
Vaccinated:1992-05-12
Onset:1992-05-14
Submitted:1992-06-16
Entered:1992-06-24 1992-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 0119V / 0 LL / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Agitation, Coordination abnormal, Delirium, Pyrexia, AGITATION, BRAIN SYND ACUTE, FEVER, ATAXIA

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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: TB tine test
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: head CT neg; CSF neg;
CDC 'Split Type':

Write-up: pt recvd MMR vax 12MAY92 & onset of fever & fussiness; became inc fussy w/persistent crying; devel ataxia 3 days p/vax; had CT Scan, LP hospitalized for observation; pt neuro consult dx MMR rxn w/poss cerebellitis;


Changed on 5/14/2017

VAERS ID: 43115 Before After
VAERS Form:
Age:1.0
Sex:Female
Location:California
Vaccinated:1992-05-12
Onset:1992-05-14
Submitted:1992-06-16
Entered:1992-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0119V / 0 LL / IM

Administered by: Private      Purchased by: Private
Symptoms: Agitation, Coordination abnormal, Delirium, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: TB tine test
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: head CT neg; CSF neg;
CDC 'Split Type':

Write-up: pt recvd MMR vax 12MAY92 & onset of fever & fussiness; became inc fussy w/persistent crying; devel ataxia 3 days p/vax; had CT Scan, LP hospitalized for observation; pt neuro consult dx MMR rxn w/poss cerebellitis;


Changed on 9/14/2017

VAERS ID: 43115 Before After
VAERS Form:(blank) 1
Age:1.0
Sex:Female
Location:California
Vaccinated:1992-05-12
Onset:1992-05-14
Submitted:1992-06-16
Entered:1992-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0119V / 0 1 LL / IM

Administered by: Private      Purchased by: Private
Symptoms: Agitation, Coordination abnormal, Delirium, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: TB tine test
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: head CT neg; CSF neg;
CDC 'Split Type':

Write-up: pt recvd MMR vax 12MAY92 & onset of fever & fussiness; became inc fussy w/persistent crying; devel ataxia 3 days p/vax; had CT Scan, LP hospitalized for observation; pt neuro consult dx MMR rxn w/poss cerebellitis;


Changed on 2/14/2018

VAERS ID: 43115 Before After
VAERS Form:1
Age:1.0
Sex:Female
Location:California
Vaccinated:1992-05-12
Onset:1992-05-14
Submitted:1992-06-16
Entered:1992-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0119V / 1 LL / IM

Administered by: Private      Purchased by: Private
Symptoms: Agitation, Coordination abnormal, Delirium, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: TB tine test
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: head CT neg; CSF neg;
CDC 'Split Type':

Write-up: pt recvd MMR vax 12MAY92 & onset of fever & fussiness; became inc fussy w/persistent crying; devel ataxia 3 days p/vax; had CT Scan, LP hospitalized for observation; pt neuro consult dx MMR rxn w/poss cerebellitis;


Changed on 6/14/2018

VAERS ID: 43115 Before After
VAERS Form:1
Age:1.0
Sex:Female
Location:California
Vaccinated:1992-05-12
Onset:1992-05-14
Submitted:1992-06-16
Entered:1992-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0119V / 1 LL / IM

Administered by: Private      Purchased by: Private
Symptoms: Agitation, Coordination abnormal, Delirium, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: TB tine test
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: head CT neg; CSF neg;
CDC 'Split Type':

Write-up: pt recvd MMR vax 12MAY92 & onset of fever & fussiness; became inc fussy w/persistent crying; devel ataxia 3 days p/vax; had CT Scan, LP hospitalized for observation; pt neuro consult dx MMR rxn w/poss cerebellitis;


Changed on 8/14/2018

VAERS ID: 43115 Before After
VAERS Form:1
Age:1.0
Sex:Female
Location:California
Vaccinated:1992-05-12
Onset:1992-05-14
Submitted:1992-06-16
Entered:1992-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0119V / 1 LL / IM

Administered by: Private      Purchased by: Private
Symptoms: Agitation, Coordination abnormal, Delirium, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: TB tine test
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: head CT neg; CSF neg;
CDC 'Split Type':

Write-up: pt recvd MMR vax 12MAY92 & onset of fever & fussiness; became inc fussy w/persistent crying; devel ataxia 3 days p/vax; had CT Scan, LP hospitalized for observation; pt neuro consult dx MMR rxn w/poss cerebellitis;


Changed on 9/14/2018

VAERS ID: 43115 Before After
VAERS Form:1
Age:1.0
Sex:Female
Location:California
Vaccinated:1992-05-12
Onset:1992-05-14
Submitted:1992-06-16
Entered:1992-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0119V / 1 LL / IM

Administered by: Private      Purchased by: Private
Symptoms: Agitation, Coordination abnormal, Delirium, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: TB tine test
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: head CT neg; CSF neg;
CDC 'Split Type':

Write-up: pt recvd MMR vax 12MAY92 & onset of fever & fussiness; became inc fussy w/persistent crying; devel ataxia 3 days p/vax; had CT Scan, LP hospitalized for observation; pt neuro consult dx MMR rxn w/poss cerebellitis;


Changed on 10/14/2018

VAERS ID: 43115 Before After
VAERS Form:1
Age:1.0
Sex:Female
Location:California
Vaccinated:1992-05-12
Onset:1992-05-14
Submitted:1992-06-16
Entered:1992-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0119V / 1 LL / IM

Administered by: Private      Purchased by: Private
Symptoms: Agitation, Coordination abnormal, Delirium, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: TB tine test
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: head CT neg; CSF neg;
CDC 'Split Type':

Write-up: pt recvd MMR vax 12MAY92 & onset of fever & fussiness; became inc fussy w/persistent crying; devel ataxia 3 days p/vax; had CT Scan, LP hospitalized for observation; pt neuro consult dx MMR rxn w/poss cerebellitis;

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=43115&WAYBACKHISTORY=ON


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