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| VAERS ID: | 25006 (history) | Vaccinated: | 1989-11-17 | | Age: | 16.7 | Onset: | 1989-11-17, Days after vaccination: 0 | | Gender: | Female | Submitted: | 0000-00-00 | | Location: | Ohio | Entered: | 1990-07-02 | |
| Life Threatening? No |
| Died? No |
| Permanent Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Previous Vaccinations: | | Other Medications: | | Current Illness: | | Preexisting Conditions: no hx of local or systemic rxns | | Diagnostic Lab Data: | | CDC 'Split Type': 890278001 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME) | UNKNOWN MANUFACTURER | | | | | | TD: TD ADSORBED (NO BRAND NAME) | LEDERLE LABORATORIES | 247953 | | IM | | |
| Administered by: Unknown Purchased by: Unknown | Symptoms: Convulsion,
Dizziness
SMQs:, Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Generalised convulsive seizures following immunisation (narrow)
| | Write-up: 16 yr old female feeling faint & then had seizure within a few min. /p Td/MMR immunization. MD is uncertain if seizure was due to hyperventilation episode. No treatment initiated. Pt asymptomatic. Vaccine given routine |
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| VAERS ID: | 25009 (history) | Vaccinated: | 1990-04-05 | | Age: | 3.3 | Onset: | 1990-04-06, Days after vaccination: 1 | | Gender: | Male | Submitted: | 0000-00-00 | | Location: | Florida | Entered: | 1990-07-02 | |
| Life Threatening? No |
| Died? No |
| Permanent Disability? Yes |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Previous Vaccinations: | | Other Medications: | | Current Illness: | | Preexisting Conditions: recurrent otitis media, measles | | Diagnostic Lab Data: | | CDC 'Split Type': WAES90030661 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | MMR: MEASLES + MUMPS + RUBELLA (MMR II) | MERCK & CO. INC. | 0333P | | | | |
| Administered by: Unknown Purchased by: Unknown | Symptoms: Deafness
SMQs:, Hearing impairment (narrow)
| | Write-up: 15mon. male w/ hx of recurrent ear infections & measles in Feb. 89''. 5Apr89 was given MMR. Within 24 hrs /p vaccine, parents noted hearing deficit, confirmed by physician exam. |
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| VAERS ID: | 25020 (history) | Vaccinated: | 1990-06-14 | | Age: | 4.5 | Onset: | 1990-06-14, Days after vaccination: 0 | | Gender: | Female | Submitted: | 0000-00-00 | | Location: | New York | Entered: | 1990-07-09 | |
| Life Threatening? No |
| Died? No |
| Permanent Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Previous Vaccinations: | | Other Medications: Subcut- Epinephrine, Bendryl & Solumedrol IV | | Current Illness: | | Preexisting Conditions: | | Diagnostic Lab Data: | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | MMR: MEASLES + MUMPS + RUBELLA (MMR II) | MERCK & CO. INC. | 1227S | | SC | | |
| Administered by: Private Purchased by: Unknown | Symptoms: Asthma,
Face oedema,
Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
| | Write-up: Urticaria, wheezy, & periorbital edema which abated /p administration of subcut. epinephrine, Bendryl IV, Solumendrol IV |
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| VAERS ID: | 25027 (history) | Vaccinated: | 1990-05-29 | | Age: | 1.0 | Onset: | 1990-05-31, Days after vaccination: 2 | | Gender: | Female | Submitted: | 0000-00-00 | | Location: | New York | Entered: | 1990-07-09 | |
| Life Threatening? No |
| Died? No |
| Permanent Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Previous Vaccinations: | | Other Medications: | | Current Illness: | | Preexisting Conditions: | | Diagnostic Lab Data: | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | MMR: MEASLES + MUMPS + RUBELLA (MMR II) | MERCK & CO. INC. | 1022S | | SC | | |
| Administered by: Unknown Purchased by: Unknown | Symptoms: Pyrexia,
Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
| | Write-up: fever 102.5 F, rash |
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| VAERS ID: | 25044 (history) | Vaccinated: | 1990-05-24 | | Age: | 2.0 | Onset: | 1990-05-30, Days after vaccination: 6 | | Gender: | Male | Submitted: | 0000-00-00 | | Location: | Unknown | Entered: | 1990-07-09 | |
| Life Threatening? No |
| Died? No |
| Permanent Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Previous Vaccinations: | | Other Medications: | | Current Illness: | | Preexisting Conditions: | | Diagnostic Lab Data: | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | MMR: MEASLES + MUMPS + RUBELLA (MMR II) | MERCK & CO. INC. | 12275 | | SC | | |
| Administered by: Private Purchased by: Unknown | Symptoms: Gait disturbance,
Personality disorder,
Pyrexia,
Somnolence,
Speech disorder
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad)
| | Write-up: Beginning 6 days after immunization had 3 days of fever followed by 3 days of slurred speech, wide-based gait, lethargy, and bizarre behavior, followed in turn by complete resolution. |
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| VAERS ID: | 25072 (history) | Vaccinated: | 1990-06-03 | | Age: | 16.0 | Onset: | 1990-06-05, Days after vaccination: 2 | | Gender: | Male | Submitted: | 0000-00-00 | | Location: | New York | Entered: | 1990-07-09 | |
| Life Threatening? No |
| Died? No |
| Permanent Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Previous Vaccinations: | | Other Medications: | | Current Illness: | | Preexisting Conditions: no relevant hx | | Diagnostic Lab Data: Lab test serum amylase 6Jun90 - 2000 | | CDC 'Split Type': WAES90060353 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | MMR: MEASLES + MUMPS + RUBELLA (MMR II) | MERCK & CO. INC. | | | | | |
| Administered by: Private Purchased by: Unknown | Symptoms: Abdominal pain,
Blood amylase increased,
Enzyme abnormality,
Pancreatitis
SMQs:, Acute pancreatitis (narrow), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
| | Write-up: Pt developed abdominal pain & 6Jun90 admitted to hosp. DX pancreatisis & required surgery |
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| VAERS ID: | 25131 (history) | Vaccinated: | 1990-06-25 | | Age: | 18.0 | Onset: | 1990-06-28, Days after vaccination: 3 | | Gender: | Female | Submitted: | 0000-00-00 | | Location: | Connecticut | Entered: | 1990-07-09 | |
| Life Threatening? No |
| Died? No |
| Permanent Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Previous Vaccinations: | | Other Medications: | | Current Illness: | | Preexisting Conditions: | | Diagnostic Lab Data: | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | MMR: MEASLES + MUMPS + RUBELLA (MMR II) | MERCK & CO. INC. | 2130R | | | | |
| Administered by: Unknown Purchased by: Unknown | Symptoms: Arthralgia,
Asthenia,
Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad)
| | Write-up: Fever of 102 F, achy joints, fatigue |
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| VAERS ID: | 25136 (history) | Vaccinated: | 1989-11-03 | | Age: | 1.5 | Onset: | 1989-11-03, Days after vaccination: 0 | | Gender: | Female | Submitted: | 0000-00-00 | | Location: | California | Entered: | 1990-07-09 | |
| Life Threatening? No |
| Died? No |
| Permanent Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Previous Vaccinations: | | Other Medications: | | Current Illness: | | Preexisting Conditions: | | Diagnostic Lab Data: | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | DT: DT ADSORBED (NO BRAND NAME) | LEDERLE LABORATORIES | 246797 | | IM | | | MMR: MEASLES + MUMPS + RUBELLA (MMR II) | MERCK & CO. INC. | 0146R | | IM | | | OPV: POLIO VIRUS, ORAL (ORIMUNE) | LEDERLE LABORATORIES | | | | | |
| Administered by: Private Purchased by: Private | Symptoms: Convulsion,
Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
| | Write-up: PT HAD HIGH FEVER (105 F). BRIEF GENERALIZED SIEZURE |
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| VAERS ID: | 25137 (history) | Vaccinated: | 1990-05-28 | | Age: | 5.0 | Onset: | 1990-05-28, Days after vaccination: 0 | | Gender: | Female | Submitted: | 0000-00-00 | | Location: | Virginia | Entered: | 1990-07-09 | |
| Life Threatening? No |
| Died? No |
| Permanent Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Previous Vaccinations: | | Other Medications: | | Current Illness: | | Preexisting Conditions: | | Diagnostic Lab Data: | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | DTP: DTP (TRI-IMMUNOL) | LEDERLE LABORATORIES | 262913 | | IM | | | MMR: MEASLES + MUMPS + RUBELLA (MMR II) | MERCK & CO. INC. | 05595/2414R | | | | | OPV: POLIO VIRUS, ORAL (ORIMUNE) | LEDERLE LABORATORIES | 277943 | | | | |
| Administered by: Private Purchased by: Unknown | Symptoms: Bradycardia,
Hypotension,
Stupor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad)
| | Write-up: PT HAD INTERMITTENT BRADYCARDIA, LOW BP AND ALTERED CONSCIOUSNESS. |
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| VAERS ID: | 25431 (history) | Vaccinated: | 1990-06-05 | | Age: | 1.3 | Onset: | 1990-06-05, Days after vaccination: 0 | | Gender: | Female | Submitted: | 0000-00-00 | | Location: | Illinois | Entered: | 1990-07-09 | |
| Life Threatening? No |
| Died? No |
| Permanent Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Previous Vaccinations: | | Other Medications: | | Current Illness: | | Preexisting Conditions: | | Diagnostic Lab Data: LUMBAR PUNCTURE NEGATIVE ,CTSCAN HEAD- NEGATIVE, UBC 4,300 | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | MMR: MEASLES + MUMPS + RUBELLA (MMR II) | MERCK & CO. INC. | 1388R | | SC | | |
| Administered by: Private Purchased by: Private | Symptoms: Convulsion,
Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
| | Write-up: 6 HRS AFTER VACCINE, FEVER AND SEIZURE(LEFT FOCAL SEIZURE) |
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