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This is VAERS ID 223056

Case Details

VAERS ID: 223056 (history)  
Form: Version 1.0  
Age: 27.0  
Sex: Male  
Location: Unknown  
Vaccinated:2003-05-16
Onset:2003-05-18
   Days after vaccination:2
Submitted: 2004-05-28
   Days after onset:376
Entered: 2004-06-22
   Days after submission:25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK - / -
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0004M / UNK - / SC
MNQ: MENINGOCOCCAL CONJUGATE (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
TYP: TYPHOID LIVE ORAL TY21A (VIVOTIF) / BERNA BIOTECH, LTD. - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Ear pain, Parotitis, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal infections (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: UNK
CDC Split Type: WAES0305USA02294

Write-up: Information has been received from a nurse concerning a 27 year old male with no drug allergies who on 16MAY2003 was vaccinated with measles virus vaccine live + mumps virus vaccine live + rubella virus vaccine live (second generation) 0.5 ml subcutaneously. Concomitant therapy included hepatitis A vaccine, meningitis vaccine, poliovirus vaccine inactivated and yellow fever virus vaccine live. The health care provider reported that the patient was vaccinated with numerous vaccines on the same day. The vaccines were administered at different anatomical sites. On 18MAY2003 the patient experienced left side parotiditis, ear pain and swelling of the mouth. The patient did seek medical attention and was using Tylenol and Aleve for relief, but the nurse said that no treatment was recommended at this time. At the time of this report the outcome was unknown. Additional information has been requested.


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