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This is VAERS ID 25004

Case Details

VAERS ID: 25004 (history)  
Age: 0.9  
Gender: Male  
Location: New York  
Vaccinated:1989-11-13
Onset:1989-11-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 232961 / - - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Chills, Dermatitis contact, Oedema genital, Pelvic pain
SMQs:, Angioedema (broad), Hypersensitivity (narrow)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 890269201

Write-up: Pt developed chills for approx. 1 hr, felt achy all over, genital area turned red with some swelling, no pain 24 hrs later, now has pain in genital area. Genitals pain, swelling, redness for 8 days. Fever, dematitis contact, rigors


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