VAERS ID: |
25131 (history) |
Form: |
Version 1.0 |
Age: |
18.0 |
Gender: |
Female |
Location: |
Connecticut |
Vaccinated: | 1990-06-25 |
Onset: | 1990-06-28 |
Days after vaccination: | 3 |
Submitted: |
0000-00-00 |
Entered: |
1990-07-09 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. |
2130R / UNK |
- / - |
Administered by: Unknown Purchased by: Unknown Symptoms: Arthralgia,
Asthenia,
Pyrexia SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Arthritis (broad), 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: ~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type:
Write-up: Fever of 102 F, achy joints, fatigue |