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This is VAERS ID 25485

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 25485
VAERS Form:
Age:1.3
Sex:Male
Location:New York
Vaccinated:1990-02-26
Onset:1990-03-10
Submitted:0000-00-00
Entered:1990-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II / MSD 409672130R / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: FEVER, RASH MAC PAP, VASCULITIS, LIVER FUNC ABNORM

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: no relevant hx
Allergies:
Diagnostic Lab Data: WBC- 37,700, platlets- 379,000, LDH- 1,000, SGOT- 50, sepsis work-up was neg. Additional lab data on WORM
CDC 'Split Type':

Write-up: 12 days/p vaccination, developed maculopapular rash on face, arms & legs. Became jumpy fussy, had fever 104 F- hospitalized, sysmtoms persisted for approx. 4 wks, subsequently rash became pigmented, DX as vasculitis

Changed on 12/8/2009

VAERS ID: 25485 Before After
VAERS Form:
Age:1.3
Sex:Male
Location:New York
Vaccinated:1990-02-26
Onset:1990-03-10
Submitted:0000-00-00
Entered:1990-07-18 1990-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 409672130R / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Hepatic function abnormal, Pyrexia, Rash maculo-papular, Vasculitis, FEVER, RASH MAC PAP, VASCULITIS, LIVER FUNC ABNORM

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: no relevant hx
Allergies:
Diagnostic Lab Data: WBC- 37,700, platlets- 379,000, LDH- 1,000, SGOT- 50, sepsis work-up was neg. Additional lab data on WORM
CDC 'Split Type': (blank) WAES90031176

Write-up: 12 days/p vaccination, developed maculopapular rash on face, arms & legs. Became jumpy fussy, had fever 104 F- hospitalized, sysmtoms persisted for approx. 4 wks, subsequently rash became pigmented, DX as vasculitis

Changed on 5/14/2017

VAERS ID: 25485 Before After
VAERS Form:
Age:1.3
Sex:Male
Location:New York
Vaccinated:1990-02-26
Onset:1990-03-10
Submitted:0000-00-00
Entered:1990-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 409672130R / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Hepatic function abnormal, Pyrexia, Rash maculo-papular, Vasculitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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: WBC- 37,700, platlets- 379,000, LDH- 1,000, SGOT- 50, sepsis work-up was neg. Additional lab data on WORM
CDC 'Split Type': WAES90031176

Write-up: 12 days/p vaccination, developed maculopapular rash on face, arms & legs. Became jumpy fussy, had fever 104 F- hospitalized, sysmtoms persisted for approx. 4 wks, subsequently rash became pigmented, DX as vasculitis

Changed on 9/14/2017

VAERS ID: 25485 Before After
VAERS Form:(blank) 1
Age:1.3
Sex:Male
Location:New York
Vaccinated:1990-02-26
Onset:1990-03-10
Submitted:0000-00-00
Entered:1990-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 409672130R / - UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Hepatic function abnormal, Pyrexia, Rash maculo-papular, Vasculitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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: WBC- 37,700, platlets- 379,000, LDH- 1,000, SGOT- 50, sepsis work-up was neg. Additional lab data on WORM
CDC 'Split Type': WAES90031176

Write-up: 12 days/p vaccination, developed maculopapular rash on face, arms & legs. Became jumpy fussy, had fever 104 F- hospitalized, sysmtoms persisted for approx. 4 wks, subsequently rash became pigmented, DX as vasculitis

Changed on 2/14/2018

VAERS ID: 25485 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:New York
Vaccinated:1990-02-26
Onset:1990-03-10
Submitted:0000-00-00
Entered:1990-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 409672130R / UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Hepatic function abnormal, Pyrexia, Rash maculo-papular, Vasculitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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: WBC- 37,700, platlets- 379,000, LDH- 1,000, SGOT- 50, sepsis work-up was neg. Additional lab data on WORM
CDC 'Split Type': WAES90031176

Write-up: 12 days/p vaccination, developed maculopapular rash on face, arms & legs. Became jumpy fussy, had fever 104 F- hospitalized, sysmtoms persisted for approx. 4 wks, subsequently rash became pigmented, DX as vasculitis

Changed on 6/14/2018

VAERS ID: 25485 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:New York
Vaccinated:1990-02-26
Onset:1990-03-10
Submitted:0000-00-00
Entered:1990-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 409672130R / UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Hepatic function abnormal, Pyrexia, Rash maculo-papular, Vasculitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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: WBC- 37,700, platlets- 379,000, LDH- 1,000, SGOT- 50, sepsis work-up was neg. Additional lab data on WORM
CDC 'Split Type': WAES90031176

Write-up: 12 days/p vaccination, developed maculopapular rash on face, arms & legs. Became jumpy fussy, had fever 104 F- hospitalized, sysmtoms persisted for approx. 4 wks, subsequently rash became pigmented, DX as vasculitis

Changed on 8/14/2018

VAERS ID: 25485 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:New York
Vaccinated:1990-02-26
Onset:1990-03-10
Submitted:0000-00-00
Entered:1990-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 409672130R / UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Hepatic function abnormal, Pyrexia, Rash maculo-papular, Vasculitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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: WBC- 37,700, platlets- 379,000, LDH- 1,000, SGOT- 50, sepsis work-up was neg. Additional lab data on WORM
CDC 'Split Type': WAES90031176

Write-up: 12 days/p vaccination, developed maculopapular rash on face, arms & legs. Became jumpy fussy, had fever 104 F- hospitalized, sysmtoms persisted for approx. 4 wks, subsequently rash became pigmented, DX as vasculitis

Changed on 9/14/2018

VAERS ID: 25485 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:New York
Vaccinated:1990-02-26
Onset:1990-03-10
Submitted:0000-00-00
Entered:1990-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 409672130R / UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Hepatic function abnormal, Pyrexia, Rash maculo-papular, Vasculitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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: WBC- 37,700, platlets- 379,000, LDH- 1,000, SGOT- 50, sepsis work-up was neg. Additional lab data on WORM
CDC 'Split Type': WAES90031176

Write-up: 12 days/p vaccination, developed maculopapular rash on face, arms & legs. Became jumpy fussy, had fever 104 F- hospitalized, sysmtoms persisted for approx. 4 wks, subsequently rash became pigmented, DX as vasculitis

Changed on 10/14/2018

VAERS ID: 25485 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:New York
Vaccinated:1990-02-26
Onset:1990-03-10
Submitted:0000-00-00
Entered:1990-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 409672130R / UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Hepatic function abnormal, Pyrexia, Rash maculo-papular, Vasculitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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: WBC- 37,700, platlets- 379,000, LDH- 1,000, SGOT- 50, sepsis work-up was neg. Additional lab data on WORM
CDC 'Split Type': WAES90031176

Write-up: 12 days/p vaccination, developed maculopapular rash on face, arms & legs. Became jumpy fussy, had fever 104 F- hospitalized, sysmtoms persisted for approx. 4 wks, subsequently rash became pigmented, DX as vasculitis

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