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This is VAERS ID 214003

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 214003
VAERS Form:
Age:2.7
Sex:Female
Location:Foreign
Vaccinated:2003-02-28
Onset:2003-02-28
Submitted:2003-12-10
Entered:2003-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. C2831 / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Laboratory test abnormal, Neoplasm, Pyrexia, Sarcoma

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2003-11-27
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Ultrasound: there is a low echo area where an artery passes through. Diagnostic pathological examination: parvicellular malignant tumor probably originated from granulocytic sarcoma. Bone biopsy: eosinophilic granulocyte increased, neutroph
CDC 'Split Type': WAES0312CHN00004

Write-up: Information has been received from a physician concerning a 34 month old girl who at 1:00 PM, 2/28/03 was vaccinated with MMR, 0.5 ml, IM. In the evening of 2/28/03, the girl experienced fever with 38.5 of body temperature. At 7:00 PM, 2/28/03, the girl developed a 0.5x0.5cm square of mass around her right ear. On 5/1/03, she was placed on fomentation therapy (detail unknown) for the treatment of the mass under doctor''s suggestion. On 3/25/03, the girl recovered from fever. On 4/29/03, the girl was hospitalized because the mass increased to 4x2cm square. The physical examination showed the mass was middle texture with clear borderline, coarse surface and limited mobility. At the time, the result of her blood examination revealed 7.7 of white blood cell count, 35.1 of blood lymphocyte count, 59.4 of blood neutrophil count, 2.7 of blood platelet count and 100 of blood hemoglobin. On the same day, her right ear ultrasound result showed there was a low echo area where an artery passes through. On 4/30/03, the girl was diagnosed with parvicellular malignant tumor in right parotid gland via diagnostic pathological examination. The physician estimated the parvicellular malignant tumor probably originated from granulocytic sarcoma in lymphatic and hematopoietic system. On 5/9/03, the result of her bone biopsy revealed her eosinophilic granulocyte and neutrophil alkaline phosphatase were increased. On 11/27/03, the girl died because of parvicellular malignant tumor in right parotid gland. The reporting physician felt the girl''s parvicellular malignant tumor in right glad region was definitely not related to the vaccination with MMR. Additional information is not expected.


Changed on 2/14/2017

VAERS ID: 214003 Before After
VAERS Form:
Age:2.7
Sex:Female
Location:Foreign
Vaccinated:2003-02-28
Onset:2003-02-28
Submitted:2003-12-10
Entered:2003-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. C2831 / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Laboratory test abnormal, Neoplasm, Pyrexia, Sarcoma

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2003-11-27
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Ultrasound: there is a low echo area where an artery passes through. Diagnostic pathological examination: parvicellular malignant tumor probably originated from granulocytic sarcoma. Bone biopsy: eosinophilic granulocyte increased, neutroph neutrophil alkaline phosphatase increased. Body temp 38.5 C. WBC normal. Hemoglobin decreased. Lymphocyte count normal. Neutrophil count normal; Platelet count decreased.
CDC 'Split Type': WAES0312CHN00004

Write-up: Information has been received from a physician concerning a 34 month old girl who at 1:00 PM, 2/28/03 was vaccinated with MMR, 0.5 ml, IM. In the evening of 2/28/03, the girl experienced fever with 38.5 of body temperature. At 7:00 PM, 2/28/03, the girl developed a 0.5x0.5cm square of mass around her right ear. On 5/1/03, she was placed on fomentation therapy (detail unknown) for the treatment of the mass under doctor''s suggestion. On 3/25/03, the girl recovered from fever. On 4/29/03, the girl was hospitalized because the mass increased to 4x2cm square. The physical examination showed the mass was middle texture with clear borderline, coarse surface and limited mobility. At the time, the result of her blood examination revealed 7.7 of white blood cell count, 35.1 of blood lymphocyte count, 59.4 of blood neutrophil count, 2.7 of blood platelet count and 100 of blood hemoglobin. On the same day, her right ear ultrasound result showed there was a low echo area where an artery passes through. On 4/30/03, the girl was diagnosed with parvicellular malignant tumor in right parotid gland via diagnostic pathological examination. The physician estimated the parvicellular malignant tumor probably originated from granulocytic sarcoma in lymphatic and hematopoietic system. On 5/9/03, the result of her bone biopsy revealed her eosinophilic granulocyte and neutrophil alkaline phosphatase were increased. On 11/27/03, the girl died because of parvicellular malignant tumor in right parotid gland. The reporting physician felt the girl''s parvicellular malignant tumor in right glad region was definitely not related to the vaccination with MMR. Additional information is not expected.


Changed on 9/14/2017

VAERS ID: 214003 Before After
VAERS Form:(blank) 1
Age:2.7
Sex:Female
Location:Foreign
Vaccinated:2003-02-28
Onset:2003-02-28
Submitted:2003-12-10
Entered:2003-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. C2831 / - UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Laboratory test abnormal, Neoplasm, Pyrexia, Sarcoma

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2003-11-27
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Ultrasound: there is a low echo area where an artery passes through. Diagnostic pathological examination: parvicellular malignant tumor probably originated from granulocytic sarcoma. Bone biopsy: eosinophilic granulocyte increased, neutrophil alkaline phosphatase increased. Body temp 38.5 C. WBC normal. Hemoglobin decreased. Lymphocyte count normal. Neutrophil count normal; Platelet count decreased.
CDC 'Split Type': WAES0312CHN00004

Write-up: Information has been received from a physician concerning a 34 month old girl who at 1:00 PM, 2/28/03 was vaccinated with MMR, 0.5 ml, IM. In the evening of 2/28/03, the girl experienced fever with 38.5 of body temperature. At 7:00 PM, 2/28/03, the girl developed a 0.5x0.5cm square of mass around her right ear. On 5/1/03, she was placed on fomentation therapy (detail unknown) for the treatment of the mass under doctor''s suggestion. On 3/25/03, the girl recovered from fever. On 4/29/03, the girl was hospitalized because the mass increased to 4x2cm square. The physical examination showed the mass was middle texture with clear borderline, coarse surface and limited mobility. At the time, the result of her blood examination revealed 7.7 of white blood cell count, 35.1 of blood lymphocyte count, 59.4 of blood neutrophil count, 2.7 of blood platelet count and 100 of blood hemoglobin. On the same day, her right ear ultrasound result showed there was a low echo area where an artery passes through. On 4/30/03, the girl was diagnosed with parvicellular malignant tumor in right parotid gland via diagnostic pathological examination. The physician estimated the parvicellular malignant tumor probably originated from granulocytic sarcoma in lymphatic and hematopoietic system. On 5/9/03, the result of her bone biopsy revealed her eosinophilic granulocyte and neutrophil alkaline phosphatase were increased. On 11/27/03, the girl died because of parvicellular malignant tumor in right parotid gland. The reporting physician felt the girl''s parvicellular malignant tumor in right glad region was definitely not related to the vaccination with MMR. Additional information is not expected.


Changed on 2/14/2018

VAERS ID: 214003 Before After
VAERS Form:1
Age:2.7
Sex:Female
Location:Foreign
Vaccinated:2003-02-28
Onset:2003-02-28
Submitted:2003-12-10
Entered:2003-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. C2831 / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Laboratory test abnormal, Neoplasm, Pyrexia, Sarcoma

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2003-11-27
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Ultrasound: there is a low echo area where an artery passes through. Diagnostic pathological examination: parvicellular malignant tumor probably originated from granulocytic sarcoma. Bone biopsy: eosinophilic granulocyte increased, neutrophil alkaline phosphatase increased. Body temp 38.5 C. WBC normal. Hemoglobin decreased. Lymphocyte count normal. Neutrophil count normal; Platelet count decreased.
CDC 'Split Type': WAES0312CHN00004

Write-up: Information has been received from a physician concerning a 34 month old girl who at 1:00 PM, 2/28/03 was vaccinated with MMR, 0.5 ml, IM. In the evening of 2/28/03, the girl experienced fever with 38.5 of body temperature. At 7:00 PM, 2/28/03, the girl developed a 0.5x0.5cm square of mass around her right ear. On 5/1/03, she was placed on fomentation therapy (detail unknown) for the treatment of the mass under doctor''s suggestion. On 3/25/03, the girl recovered from fever. On 4/29/03, the girl was hospitalized because the mass increased to 4x2cm square. The physical examination showed the mass was middle texture with clear borderline, coarse surface and limited mobility. At the time, the result of her blood examination revealed 7.7 of white blood cell count, 35.1 of blood lymphocyte count, 59.4 of blood neutrophil count, 2.7 of blood platelet count and 100 of blood hemoglobin. On the same day, her right ear ultrasound result showed there was a low echo area where an artery passes through. On 4/30/03, the girl was diagnosed with parvicellular malignant tumor in right parotid gland via diagnostic pathological examination. The physician estimated the parvicellular malignant tumor probably originated from granulocytic sarcoma in lymphatic and hematopoietic system. On 5/9/03, the result of her bone biopsy revealed her eosinophilic granulocyte and neutrophil alkaline phosphatase were increased. On 11/27/03, the girl died because of parvicellular malignant tumor in right parotid gland. The reporting physician felt the girl''s parvicellular malignant tumor in right glad region was definitely not related to the vaccination with MMR. Additional information is not expected.


Changed on 6/14/2018

VAERS ID: 214003 Before After
VAERS Form:1
Age:2.7
Sex:Female
Location:Foreign
Vaccinated:2003-02-28
Onset:2003-02-28
Submitted:2003-12-10
Entered:2003-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. C2831 / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Laboratory test abnormal, Neoplasm, Pyrexia, Sarcoma

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2003-11-27
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Ultrasound: there is a low echo area where an artery passes through. Diagnostic pathological examination: parvicellular malignant tumor probably originated from granulocytic sarcoma. Bone biopsy: eosinophilic granulocyte increased, neutrophil alkaline phosphatase increased. Body temp 38.5 C. WBC normal. Hemoglobin decreased. Lymphocyte count normal. Neutrophil count normal; Platelet count decreased.
CDC 'Split Type': WAES0312CHN00004

Write-up: Information has been received from a physician concerning a 34 month old girl who at 1:00 PM, 2/28/03 was vaccinated with MMR, 0.5 ml, IM. In the evening of 2/28/03, the girl experienced fever with 38.5 of body temperature. At 7:00 PM, 2/28/03, the girl developed a 0.5x0.5cm square of mass around her right ear. On 5/1/03, she was placed on fomentation therapy (detail unknown) for the treatment of the mass under doctor''s suggestion. On 3/25/03, the girl recovered from fever. On 4/29/03, the girl was hospitalized because the mass increased to 4x2cm square. The physical examination showed the mass was middle texture with clear borderline, coarse surface and limited mobility. At the time, the result of her blood examination revealed 7.7 of white blood cell count, 35.1 of blood lymphocyte count, 59.4 of blood neutrophil count, 2.7 of blood platelet count and 100 of blood hemoglobin. On the same day, her right ear ultrasound result showed there was a low echo area where an artery passes through. On 4/30/03, the girl was diagnosed with parvicellular malignant tumor in right parotid gland via diagnostic pathological examination. The physician estimated the parvicellular malignant tumor probably originated from granulocytic sarcoma in lymphatic and hematopoietic system. On 5/9/03, the result of her bone biopsy revealed her eosinophilic granulocyte and neutrophil alkaline phosphatase were increased. On 11/27/03, the girl died because of parvicellular malignant tumor in right parotid gland. The reporting physician felt the girl''s parvicellular malignant tumor in right glad region was definitely not related to the vaccination with MMR. Additional information is not expected.


Changed on 8/14/2018

VAERS ID: 214003 Before After
VAERS Form:1
Age:2.7
Sex:Female
Location:Foreign
Vaccinated:2003-02-28
Onset:2003-02-28
Submitted:2003-12-10
Entered:2003-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. C2831 / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Laboratory test abnormal, Neoplasm, Pyrexia, Sarcoma

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2003-11-27
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Ultrasound: there is a low echo area where an artery passes through. Diagnostic pathological examination: parvicellular malignant tumor probably originated from granulocytic sarcoma. Bone biopsy: eosinophilic granulocyte increased, neutrophil alkaline phosphatase increased. Body temp 38.5 C. WBC normal. Hemoglobin decreased. Lymphocyte count normal. Neutrophil count normal; Platelet count decreased.
CDC 'Split Type': WAES0312CHN00004

Write-up: Information has been received from a physician concerning a 34 month old girl who at 1:00 PM, 2/28/03 was vaccinated with MMR, 0.5 ml, IM. In the evening of 2/28/03, the girl experienced fever with 38.5 of body temperature. At 7:00 PM, 2/28/03, the girl developed a 0.5x0.5cm square of mass around her right ear. On 5/1/03, she was placed on fomentation therapy (detail unknown) for the treatment of the mass under doctor''s suggestion. On 3/25/03, the girl recovered from fever. On 4/29/03, the girl was hospitalized because the mass increased to 4x2cm square. The physical examination showed the mass was middle texture with clear borderline, coarse surface and limited mobility. At the time, the result of her blood examination revealed 7.7 of white blood cell count, 35.1 of blood lymphocyte count, 59.4 of blood neutrophil count, 2.7 of blood platelet count and 100 of blood hemoglobin. On the same day, her right ear ultrasound result showed there was a low echo area where an artery passes through. On 4/30/03, the girl was diagnosed with parvicellular malignant tumor in right parotid gland via diagnostic pathological examination. The physician estimated the parvicellular malignant tumor probably originated from granulocytic sarcoma in lymphatic and hematopoietic system. On 5/9/03, the result of her bone biopsy revealed her eosinophilic granulocyte and neutrophil alkaline phosphatase were increased. On 11/27/03, the girl died because of parvicellular malignant tumor in right parotid gland. The reporting physician felt the girl''s parvicellular malignant tumor in right glad region was definitely not related to the vaccination with MMR. Additional information is not expected.


Changed on 9/14/2018

VAERS ID: 214003 Before After
VAERS Form:1
Age:2.7
Sex:Female
Location:Foreign
Vaccinated:2003-02-28
Onset:2003-02-28
Submitted:2003-12-10
Entered:2003-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. C2831 / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Laboratory test abnormal, Neoplasm, Pyrexia, Sarcoma

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2003-11-27
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Ultrasound: there is a low echo area where an artery passes through. Diagnostic pathological examination: parvicellular malignant tumor probably originated from granulocytic sarcoma. Bone biopsy: eosinophilic granulocyte increased, neutrophil alkaline phosphatase increased. Body temp 38.5 C. WBC normal. Hemoglobin decreased. Lymphocyte count normal. Neutrophil count normal; Platelet count decreased.
CDC 'Split Type': WAES0312CHN00004

Write-up: Information has been received from a physician concerning a 34 month old girl who at 1:00 PM, 2/28/03 was vaccinated with MMR, 0.5 ml, IM. In the evening of 2/28/03, the girl experienced fever with 38.5 of body temperature. At 7:00 PM, 2/28/03, the girl developed a 0.5x0.5cm square of mass around her right ear. On 5/1/03, she was placed on fomentation therapy (detail unknown) for the treatment of the mass under doctor''s suggestion. On 3/25/03, the girl recovered from fever. On 4/29/03, the girl was hospitalized because the mass increased to 4x2cm square. The physical examination showed the mass was middle texture with clear borderline, coarse surface and limited mobility. At the time, the result of her blood examination revealed 7.7 of white blood cell count, 35.1 of blood lymphocyte count, 59.4 of blood neutrophil count, 2.7 of blood platelet count and 100 of blood hemoglobin. On the same day, her right ear ultrasound result showed there was a low echo area where an artery passes through. On 4/30/03, the girl was diagnosed with parvicellular malignant tumor in right parotid gland via diagnostic pathological examination. The physician estimated the parvicellular malignant tumor probably originated from granulocytic sarcoma in lymphatic and hematopoietic system. On 5/9/03, the result of her bone biopsy revealed her eosinophilic granulocyte and neutrophil alkaline phosphatase were increased. On 11/27/03, the girl died because of parvicellular malignant tumor in right parotid gland. The reporting physician felt the girl''s parvicellular malignant tumor in right glad region was definitely not related to the vaccination with MMR. Additional information is not expected.


Changed on 10/14/2018

VAERS ID: 214003 Before After
VAERS Form:1
Age:2.7
Sex:Female
Location:Foreign
Vaccinated:2003-02-28
Onset:2003-02-28
Submitted:2003-12-10
Entered:2003-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. C2831 / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Laboratory test abnormal, Neoplasm, Pyrexia, Sarcoma

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2003-11-27
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Ultrasound: there is a low echo area where an artery passes through. Diagnostic pathological examination: parvicellular malignant tumor probably originated from granulocytic sarcoma. Bone biopsy: eosinophilic granulocyte increased, neutrophil alkaline phosphatase increased. Body temp 38.5 C. WBC normal. Hemoglobin decreased. Lymphocyte count normal. Neutrophil count normal; Platelet count decreased.
CDC 'Split Type': WAES0312CHN00004

Write-up: Information has been received from a physician concerning a 34 month old girl who at 1:00 PM, 2/28/03 was vaccinated with MMR, 0.5 ml, IM. In the evening of 2/28/03, the girl experienced fever with 38.5 of body temperature. At 7:00 PM, 2/28/03, the girl developed a 0.5x0.5cm square of mass around her right ear. On 5/1/03, she was placed on fomentation therapy (detail unknown) for the treatment of the mass under doctor''s suggestion. On 3/25/03, the girl recovered from fever. On 4/29/03, the girl was hospitalized because the mass increased to 4x2cm square. The physical examination showed the mass was middle texture with clear borderline, coarse surface and limited mobility. At the time, the result of her blood examination revealed 7.7 of white blood cell count, 35.1 of blood lymphocyte count, 59.4 of blood neutrophil count, 2.7 of blood platelet count and 100 of blood hemoglobin. On the same day, her right ear ultrasound result showed there was a low echo area where an artery passes through. On 4/30/03, the girl was diagnosed with parvicellular malignant tumor in right parotid gland via diagnostic pathological examination. The physician estimated the parvicellular malignant tumor probably originated from granulocytic sarcoma in lymphatic and hematopoietic system. On 5/9/03, the result of her bone biopsy revealed her eosinophilic granulocyte and neutrophil alkaline phosphatase were increased. On 11/27/03, the girl died because of parvicellular malignant tumor in right parotid gland. The reporting physician felt the girl''s parvicellular malignant tumor in right glad region was definitely not related to the vaccination with MMR. Additional information is not expected.

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