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This is VAERS ID 26975

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 26975
VAERS Form:
Age:15.0
Sex:Male
Location:Missouri
Vaccinated:0000-00-00
Onset:1990-10-29
Submitted:0000-00-00
Entered:1990-12-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II / MSD 13135 / - - / -
TD: TD ADSORBED, ADULTS / CONNAUGHT LABS 0G21157 / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: DIZZINESS, NAUSEA, VOMIT, PAIN CHEST

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: Denies hx of allergies, incl egg allergies.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with TD/MMR c/o nausea, vomiting, chest pain, no audible B/P initially, dizziness, to emergency room B/P 112/78.


Changed on 12/8/2009

VAERS ID: 26975 Before After
VAERS Form:
Age:15.0
Sex:Male
Location:Missouri
Vaccinated:0000-00-00
Onset:1990-10-29
Submitted:0000-00-00
Entered:1990-12-14 1990-12-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 13135 / - - / -
TD: TD ADSORBED, ADULTS TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABS CONNAUGHT LABORATORIES 0G21157 / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Chest pain, Dizziness, Nausea, Vomiting, DIZZINESS, NAUSEA, VOMIT, PAIN CHEST

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: Denies hx of allergies, incl egg allergies.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with TD/MMR c/o nausea, vomiting, chest pain, no audible B/P initially, dizziness, to emergency room B/P 112/78.


Changed on 5/14/2017

VAERS ID: 26975 Before After
VAERS Form:
Age:15.0
Sex:Male
Location:Missouri
Vaccinated:0000-00-00
Onset:1990-10-29
Submitted:0000-00-00
Entered:1990-12-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 13135 / - - / -
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES 0G21157 / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Chest pain, Dizziness, Nausea, Vomiting

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: Denies hx of allergies, incl egg allergies.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with TD/MMR c/o nausea, vomiting, chest pain, no audible B/P initially, dizziness, to emergency room B/P 112/78.


Changed on 9/14/2017

VAERS ID: 26975 Before After
VAERS Form:(blank) 1
Age:15.0
Sex:Male
Location:Missouri
Vaccinated:0000-00-00
Onset:1990-10-29
Submitted:0000-00-00
Entered:1990-12-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 13135 / - UNK - / -
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES 0G21157 / - UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Chest pain, Dizziness, Nausea, Vomiting

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: Denies hx of allergies, incl egg allergies.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with TD/MMR c/o nausea, vomiting, chest pain, no audible B/P initially, dizziness, to emergency room B/P 112/78.


Changed on 2/14/2018

VAERS ID: 26975 Before After
VAERS Form:1
Age:15.0
Sex:Male
Location:Missouri
Vaccinated:0000-00-00
Onset:1990-10-29
Submitted:0000-00-00
Entered:1990-12-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 13135 / UNK - / -
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES 0G21157 / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Chest pain, Dizziness, Nausea, Vomiting

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: Denies hx of allergies, incl egg allergies.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with TD/MMR c/o nausea, vomiting, chest pain, no audible B/P initially, dizziness, to emergency room B/P 112/78.


Changed on 6/14/2018

VAERS ID: 26975 Before After
VAERS Form:1
Age:15.0
Sex:Male
Location:Missouri
Vaccinated:0000-00-00
Onset:1990-10-29
Submitted:0000-00-00
Entered:1990-12-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 13135 / UNK - / -
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES 0G21157 / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Chest pain, Dizziness, Nausea, Vomiting

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: Denies hx of allergies, incl egg allergies.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with TD/MMR c/o nausea, vomiting, chest pain, no audible B/P initially, dizziness, to emergency room B/P 112/78.


Changed on 8/14/2018

VAERS ID: 26975 Before After
VAERS Form:1
Age:15.0
Sex:Male
Location:Missouri
Vaccinated:0000-00-00
Onset:1990-10-29
Submitted:0000-00-00
Entered:1990-12-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 13135 / UNK - / -
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES 0G21157 / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Chest pain, Dizziness, Nausea, Vomiting

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: Denies hx of allergies, incl egg allergies.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with TD/MMR c/o nausea, vomiting, chest pain, no audible B/P initially, dizziness, to emergency room B/P 112/78.


Changed on 9/14/2018

VAERS ID: 26975 Before After
VAERS Form:1
Age:15.0
Sex:Male
Location:Missouri
Vaccinated:0000-00-00
Onset:1990-10-29
Submitted:0000-00-00
Entered:1990-12-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 13135 / UNK - / -
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES 0G21157 / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Chest pain, Dizziness, Nausea, Vomiting

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: Denies hx of allergies, incl egg allergies.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with TD/MMR c/o nausea, vomiting, chest pain, no audible B/P initially, dizziness, to emergency room B/P 112/78.


Changed on 10/14/2018

VAERS ID: 26975 Before After
VAERS Form:1
Age:15.0
Sex:Male
Location:Missouri
Vaccinated:0000-00-00
Onset:1990-10-29
Submitted:0000-00-00
Entered:1990-12-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 13135 / UNK - / -
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES 0G21157 / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Chest pain, Dizziness, Nausea, Vomiting

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: Denies hx of allergies, incl egg allergies.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with TD/MMR c/o nausea, vomiting, chest pain, no audible B/P initially, dizziness, to emergency room B/P 112/78.

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