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This is VAERS ID 25921

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 25921
VAERS Form:
Age:1.4
Sex:Male
Location:Ohio
Vaccinated:1990-09-06
Onset:1990-09-12
Submitted:1990-09-12
Entered:1990-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: PROHIBIT / CONNAUGHT LABS 0J11070 / - A / IM
MMR: MMR II / MSD 15715 / - L / 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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Negative LP; Negative Bloodculture
CDC 'Split Type':

Write-up: Pt vaccinated with MMR/PROHIBIT developed febrile seizure, temp to 104.5, sen at Childrens Hosp Cinci.


Changed on 12/8/2009

VAERS ID: 25921 Before After
VAERS Form:
Age:1.4
Sex:Male
Location:Ohio
Vaccinated:1990-09-06
Onset:1990-09-12
Submitted:1990-09-12
Entered:1990-09-19 1990-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: PROHIBIT HIB (PROHIBIT) / CONNAUGHT LABS CONNAUGHT LABORATORIES 0J11070 / - A / IM
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 15715 / - L / IM

Administered by: Private      Purchased by: Unknown
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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Negative LP; Negative Bloodculture
CDC 'Split Type':

Write-up: Pt vaccinated with MMR/PROHIBIT developed febrile seizure, temp to 104.5, sen at Childrens Hosp Cinci.


Changed on 5/14/2017

VAERS ID: 25921 Before After
VAERS Form:
Age:1.4
Sex:Male
Location:Ohio
Vaccinated:1990-09-06
Onset:1990-09-12
Submitted:1990-09-12
Entered:1990-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0J11070 / - A - / IM IM A
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 15715 / - L - / IM IM L

Administered by: Private      Purchased by: Unknown
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Negative LP; Negative Bloodculture
CDC 'Split Type':

Write-up: Pt vaccinated with MMR/PROHIBIT developed febrile seizure, temp to 104.5, sen at Childrens Hosp Cinci.


Changed on 9/14/2017

VAERS ID: 25921 Before After
VAERS Form:(blank) 1
Age:1.4
Sex:Male
Location:Ohio
Vaccinated:1990-09-06
Onset:1990-09-12
Submitted:1990-09-12
Entered:1990-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0J11070 / - UNK - / IM A
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 15715 / - UNK - / IM L

Administered by: Private      Purchased by: Unknown
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Negative LP; Negative Bloodculture
CDC 'Split Type':

Write-up: Pt vaccinated with MMR/PROHIBIT developed febrile seizure, temp to 104.5, sen at Childrens Hosp Cinci.


Changed on 2/14/2018

VAERS ID: 25921 Before After
VAERS Form:1
Age:1.4
Sex:Male
Location:Ohio
Vaccinated:1990-09-06
Onset:1990-09-12
Submitted:1990-09-12
Entered:1990-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0J11070 / UNK - / IM A
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 15715 / UNK - / IM L

Administered by: Private      Purchased by: Unknown
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Negative LP; Negative Bloodculture
CDC 'Split Type':

Write-up: Pt vaccinated with MMR/PROHIBIT developed febrile seizure, temp to 104.5, sen at Childrens Hosp Cinci.


Changed on 6/14/2018

VAERS ID: 25921 Before After
VAERS Form:1
Age:1.4
Sex:Male
Location:Ohio
Vaccinated:1990-09-06
Onset:1990-09-12
Submitted:1990-09-12
Entered:1990-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0J11070 / UNK - / IM A
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 15715 / UNK - / IM L

Administered by: Private      Purchased by: Unknown
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Negative LP; Negative Bloodculture
CDC 'Split Type':

Write-up: Pt vaccinated with MMR/PROHIBIT developed febrile seizure, temp to 104.5, sen at Childrens Hosp Cinci.


Changed on 8/14/2018

VAERS ID: 25921 Before After
VAERS Form:1
Age:1.4
Sex:Male
Location:Ohio
Vaccinated:1990-09-06
Onset:1990-09-12
Submitted:1990-09-12
Entered:1990-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0J11070 / UNK - / IM A
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 15715 / UNK - / IM L

Administered by: Private      Purchased by: Unknown
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Negative LP; Negative Bloodculture
CDC 'Split Type':

Write-up: Pt vaccinated with MMR/PROHIBIT developed febrile seizure, temp to 104.5, sen at Childrens Hosp Cinci.


Changed on 9/14/2018

VAERS ID: 25921 Before After
VAERS Form:1
Age:1.4
Sex:Male
Location:Ohio
Vaccinated:1990-09-06
Onset:1990-09-12
Submitted:1990-09-12
Entered:1990-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0J11070 / UNK - / IM A
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 15715 / UNK - / IM L

Administered by: Private      Purchased by: Unknown
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Negative LP; Negative Bloodculture
CDC 'Split Type':

Write-up: Pt vaccinated with MMR/PROHIBIT developed febrile seizure, temp to 104.5, sen at Childrens Hosp Cinci.


Changed on 10/14/2018

VAERS ID: 25921 Before After
VAERS Form:1
Age:1.4
Sex:Male
Location:Ohio
Vaccinated:1990-09-06
Onset:1990-09-12
Submitted:1990-09-12
Entered:1990-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0J11070 / UNK - / IM A
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 15715 / UNK - / IM L

Administered by: Private      Purchased by: Unknown
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Negative LP; Negative Bloodculture
CDC 'Split Type':

Write-up: Pt vaccinated with MMR/PROHIBIT developed febrile seizure, temp to 104.5, sen at Childrens Hosp Cinci.

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