VAERS ID: |
25006 (history) |
Form: |
Version 1.0 |
Age: |
16.0 |
Sex: |
Female |
Location: |
Ohio |
Vaccinated: | 1989-11-17 |
Onset: | 1989-11-17 |
Days after vaccination: | 0 |
Submitted: |
0000-00-00 |
Entered: |
1990-07-02 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER |
- / UNK |
- / - |
TD: TD ADSORBED (NO BRAND NAME) / LEDERLE LABORATORIES |
247953 / UNK |
- / 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), Hypoglycaemia (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: no hx of local or systemic rxns Allergies: Diagnostic Lab Data: CDC Split Type: 890278001
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 |