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This is VAERS ID 25925

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 25925
VAERS Form:
Age:12.0
Sex:Female
Location:Wisconsin
Vaccinated:1990-08-30
Onset:1990-08-30
Submitted:0000-00-00
Entered:1990-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II / MSD 1485S / - - / SC

Administered by: Private      Purchased by: Unknown
Symptoms: SYNCOPE, CONFUS, AMNESIA

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: previously very fearful of injections (IV or blood drawing)
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt had syncopal episode /p MMR shot. Subsequently had amnesia & disorientation. Could not remember place or time initially. 20 hrs /p the shot, the period of amnesia was from the injection until nightfall approx. 4-6 hrs.


Changed on 12/8/2009

VAERS ID: 25925 Before After
VAERS Form:
Age:12.0
Sex:Female
Location:Wisconsin
Vaccinated:1990-08-30
Onset:1990-08-30
Submitted:0000-00-00
Entered:1990-09-19 1990-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 1485S / - - / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Amnesia, Confusional state, Syncope, SYNCOPE, CONFUS, AMNESIA

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: previously very fearful of injections (IV or blood drawing)
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt had syncopal episode /p MMR shot. Subsequently had amnesia & disorientation. Could not remember place or time initially. 20 hrs /p the shot, the period of amnesia was from the injection until nightfall approx. 4-6 hrs.


Changed on 5/14/2017

VAERS ID: 25925 Before After
VAERS Form:
Age:12.0
Sex:Female
Location:Wisconsin
Vaccinated:1990-08-30
Onset:1990-08-30
Submitted:0000-00-00
Entered:1990-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1485S / - - / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Amnesia, Confusional state, Syncope

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: previously very fearful of injections (IV or blood drawing)
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt had syncopal episode /p MMR shot. Subsequently had amnesia & disorientation. Could not remember place or time initially. 20 hrs /p the shot, the period of amnesia was from the injection until nightfall approx. 4-6 hrs.


Changed on 9/14/2017

VAERS ID: 25925 Before After
VAERS Form:(blank) 1
Age:12.0
Sex:Female
Location:Wisconsin
Vaccinated:1990-08-30
Onset:1990-08-30
Submitted:0000-00-00
Entered:1990-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1485S / - UNK - / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Amnesia, Confusional state, Syncope

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: previously very fearful of injections (IV or blood drawing)
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt had syncopal episode /p MMR shot. Subsequently had amnesia & disorientation. Could not remember place or time initially. 20 hrs /p the shot, the period of amnesia was from the injection until nightfall approx. 4-6 hrs.


Changed on 2/14/2018

VAERS ID: 25925 Before After
VAERS Form:1
Age:12.0
Sex:Female
Location:Wisconsin
Vaccinated:1990-08-30
Onset:1990-08-30
Submitted:0000-00-00
Entered:1990-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1485S / UNK - / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Amnesia, Confusional state, Syncope

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: previously very fearful of injections (IV or blood drawing)
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt had syncopal episode /p MMR shot. Subsequently had amnesia & disorientation. Could not remember place or time initially. 20 hrs /p the shot, the period of amnesia was from the injection until nightfall approx. 4-6 hrs.


Changed on 6/14/2018

VAERS ID: 25925 Before After
VAERS Form:1
Age:12.0
Sex:Female
Location:Wisconsin
Vaccinated:1990-08-30
Onset:1990-08-30
Submitted:0000-00-00
Entered:1990-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1485S / UNK - / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Amnesia, Confusional state, Syncope

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: previously very fearful of injections (IV or blood drawing)
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt had syncopal episode /p MMR shot. Subsequently had amnesia & disorientation. Could not remember place or time initially. 20 hrs /p the shot, the period of amnesia was from the injection until nightfall approx. 4-6 hrs.


Changed on 8/14/2018

VAERS ID: 25925 Before After
VAERS Form:1
Age:12.0
Sex:Female
Location:Wisconsin
Vaccinated:1990-08-30
Onset:1990-08-30
Submitted:0000-00-00
Entered:1990-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1485S / UNK - / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Amnesia, Confusional state, Syncope

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: previously very fearful of injections (IV or blood drawing)
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt had syncopal episode /p MMR shot. Subsequently had amnesia & disorientation. Could not remember place or time initially. 20 hrs /p the shot, the period of amnesia was from the injection until nightfall approx. 4-6 hrs.


Changed on 9/14/2018

VAERS ID: 25925 Before After
VAERS Form:1
Age:12.0
Sex:Female
Location:Wisconsin
Vaccinated:1990-08-30
Onset:1990-08-30
Submitted:0000-00-00
Entered:1990-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1485S / UNK - / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Amnesia, Confusional state, Syncope

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: previously very fearful of injections (IV or blood drawing)
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt had syncopal episode /p MMR shot. Subsequently had amnesia & disorientation. Could not remember place or time initially. 20 hrs /p the shot, the period of amnesia was from the injection until nightfall approx. 4-6 hrs.


Changed on 10/14/2018

VAERS ID: 25925 Before After
VAERS Form:1
Age:12.0
Sex:Female
Location:Wisconsin
Vaccinated:1990-08-30
Onset:1990-08-30
Submitted:0000-00-00
Entered:1990-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1485S / UNK - / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Amnesia, Confusional state, Syncope

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: previously very fearful of injections (IV or blood drawing)
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt had syncopal episode /p MMR shot. Subsequently had amnesia & disorientation. Could not remember place or time initially. 20 hrs /p the shot, the period of amnesia was from the injection until nightfall approx. 4-6 hrs.

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