This is VAERS ID 25484

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History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

Vaccin­ation / Manu­facturer	Lot / Dose	Site / Route
MMR: MMR II / MSD	40967/2130R / -	- / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: FEVER, RASH MAC PAP, VASCULITIS

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 18month-old vaccinated w/MMR eighteen days after vaccination she developed a fever of 104 and macular rash of the face, torso & legs. The symptoms remitted spontaneously, recurred 2 wks later described as vasculitis. No further details.

---

Changed on 12/8/2009

Vaccin­ation / Manu­facturer	Lot / Dose	Site / Route
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC.	40967/2130R / -	- / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Pyrexia, Rash maculo-papular, Vasculitis, FEVER, RASH MAC PAP, VASCULITIS

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) WAES90040110

Write-up: 18month-old vaccinated w/MMR eighteen days after vaccination she developed a fever of 104 and macular rash of the face, torso & legs. The symptoms remitted spontaneously, recurred 2 wks later described as vasculitis. No further details.

---

Changed on 1/7/2013

Vaccin­ation / Manu­facturer	Lot / Dose	Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC.	40967/2130R / -	- / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Pyrexia, Rash maculo-papular, Vasculitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~ ~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES90040110

Write-up: 18month-old vaccinated w/MMR eighteen days after vaccination she developed a fever of 104 and macular rash of the face, torso & legs. The symptoms remitted spontaneously, recurred 2 wks later described as vasculitis. No further details.

---

Changed on 6/14/2014

Vaccin­ation / Manu­facturer	Lot / Dose	Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC.	40967/2130R / -	- / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Pyrexia, Rash maculo-papular, Vasculitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~ ~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES90040110

Write-up: 18month-old vaccinated w/MMR eighteen days after vaccination she developed a fever of 104 and macular rash of the face, torso & legs. The symptoms remitted spontaneously, recurred 2 wks later described as vasculitis. No further details.

---

Changed on 3/14/2015

Vaccin­ation / Manu­facturer	Lot / Dose	Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC.	40967/2130R / -	- / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Pyrexia, Rash maculo-papular, Vasculitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~ ~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES90040110

Write-up: 18month-old vaccinated w/MMR eighteen days after vaccination she developed a fever of 104 and macular rash of the face, torso & legs. The symptoms remitted spontaneously, recurred 2 wks later described as vasculitis. No further details.

---

Changed on 5/14/2017

Vaccin­ation / Manu­facturer	Lot / Dose	Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC.	40967/2130R / -	- / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Pyrexia, Rash maculo-papular, Vasculitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~ ~~In ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES90040110

Write-up: 18month-old vaccinated w/MMR eighteen days after vaccination she developed a fever of 104 and macular rash of the face, torso & legs. The symptoms remitted spontaneously, recurred 2 wks later described as vasculitis. No further details.

---

Changed on 9/14/2017

Vaccin­ation / Manu­facturer	Lot / Dose	Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC.	40967/2130R / - UNK	- / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Pyrexia, Rash maculo-papular, Vasculitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES90040110

Write-up: 18month-old vaccinated w/MMR eighteen days after vaccination she developed a fever of 104 and macular rash of the face, torso & legs. The symptoms remitted spontaneously, recurred 2 wks later described as vasculitis. No further details.

---

Changed on 2/14/2018

Vaccin­ation / Manu­facturer	Lot / Dose	Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC.	40967/2130R / UNK	- / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Pyrexia, Rash maculo-papular, Vasculitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES90040110

Write-up: 18month-old vaccinated w/MMR eighteen days after vaccination she developed a fever of 104 and macular rash of the face, torso & legs. The symptoms remitted spontaneously, recurred 2 wks later described as vasculitis. No further details.

---

Changed on 6/14/2018

Vaccin­ation / Manu­facturer	Lot / Dose	Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC.	40967/2130R / UNK	- / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Pyrexia, Rash maculo-papular, Vasculitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES90040110

Write-up: 18month-old vaccinated w/MMR eighteen days after vaccination she developed a fever of 104 and macular rash of the face, torso & legs. The symptoms remitted spontaneously, recurred 2 wks later described as vasculitis. No further details.

---

Changed on 8/14/2018

Vaccin­ation / Manu­facturer	Lot / Dose	Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC.	40967/2130R / UNK	- / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Pyrexia, Rash maculo-papular, Vasculitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES90040110

Write-up: 18month-old vaccinated w/MMR eighteen days after vaccination she developed a fever of 104 and macular rash of the face, torso & legs. The symptoms remitted spontaneously, recurred 2 wks later described as vasculitis. No further details.

---

Changed on 9/14/2018

Vaccin­ation / Manu­facturer	Lot / Dose	Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC.	40967/2130R / UNK	- / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Pyrexia, Rash maculo-papular, Vasculitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES90040110

Write-up: 18month-old vaccinated w/MMR eighteen days after vaccination she developed a fever of 104 and macular rash of the face, torso & legs. The symptoms remitted spontaneously, recurred 2 wks later described as vasculitis. No further details.

---

Changed on 10/14/2018

Vaccin­ation / Manu­facturer	Lot / Dose	Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC.	40967/2130R / UNK	- / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Pyrexia, Rash maculo-papular, Vasculitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES90040110

Write-up: 18month-old vaccinated w/MMR eighteen days after vaccination she developed a fever of 104 and macular rash of the face, torso & legs. The symptoms remitted spontaneously, recurred 2 wks later described as vasculitis. No further details.

---

Changed on 12/24/2020

Vaccin­ation / Manu­facturer	Lot / Dose	Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC.	40967/2130R / UNK	- / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Pyrexia, Rash maculo-papular, Vasculitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES90040110

Write-up: 18month-old vaccinated w/MMR eighteen days after vaccination she developed a fever of 104 and macular rash of the face, torso & legs. The symptoms remitted spontaneously, recurred 2 wks later described as vasculitis. No further details.

---

Changed on 12/30/2020

Vaccin­ation / Manu­facturer	Lot / Dose	Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC.	40967/2130R / UNK	- / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Pyrexia, Rash maculo-papular, Vasculitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES90040110

Write-up: 18month-old vaccinated w/MMR eighteen days after vaccination she developed a fever of 104 and macular rash of the face, torso & legs. The symptoms remitted spontaneously, recurred 2 wks later described as vasculitis. No further details.

---

Changed on 5/7/2021

Vaccin­ation / Manu­facturer	Lot / Dose	Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC.	40967/2130R / UNK	- / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Pyrexia, Rash maculo-papular, Vasculitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES90040110

Write-up: 18month-old vaccinated w/MMR eighteen days after vaccination she developed a fever of 104 and macular rash of the face, torso & legs. The symptoms remitted spontaneously, recurred 2 wks later described as vasculitis. No further details.

---

Changed on 5/21/2021

Vaccin­ation / Manu­facturer	Lot / Dose	Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC.	40967/2130R / UNK	- / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Pyrexia, Rash maculo-papular, Vasculitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES90040110

Write-up: 18month-old vaccinated w/MMR eighteen days after vaccination she developed a fever of 104 and macular rash of the face, torso & legs. The symptoms remitted spontaneously, recurred 2 wks later described as vasculitis. No further details.

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