This is VAERS ID 25072

Case Details

VAERS ID:	25072 (history)
Form:	Version 1.0
Age:	16.0
Gender:	Male
Location:	New York

Vaccinated:	1990-06-03
Onset:	1990-06-05
Days after vaccination:	2
Submitted:	0000-00-00
Entered:	1990-07-09

Vaccination / Manufacturer	Lot / Dose	Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC.	- / UNK	- / -

Administered by: Private Purchased by: Unknown
Symptoms: Abdominal pain, Blood amylase increased, Enzyme abnormality, Pancreatitis
SMQs:, Acute pancreatitis (narrow), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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? Yes, ? days
Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: no relevant hx
Allergies:
Diagnostic Lab Data: Lab test serum amylase 6Jun90 - 2000
CDC Split Type: WAES90060353

Write-up: Pt developed abdominal pain & 6Jun90 admitted to hosp. DX pancreatisis & required surgery

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