| VAERS ID: |
25072 (history) |
| Form: |
Version 1.0 |
| Age: |
16.0 |
| Sex: |
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), Immune-mediated/autoimmune disorders (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 |
