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This is VAERS ID 27145

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 27145
VAERS Form:
Age:21.1
Sex:Female
Location:Wisconsin
Vaccinated:1990-11-26
Onset:1990-12-03
Submitted:1990-12-12
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II / MSD 1794F / 0 LA / SC

Administered by: Public      Purchased by: Unknown
Symptoms: CHILLS, FEVER, MASS INJECT SITE, RASH, PAIN

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: WBC-3.9, Segs-20, Bands-40, 45% atypical lymph
CDC 'Split Type':

Write-up: Pt c/o of chills all day, T103.6, arm had great deal of pain, developed a streaky rash on inside of lt arm, to body, arm became hard, red & swollen. Went to ER.


Changed on 12/8/2009

VAERS ID: 27145 Before After
VAERS Form:
Age:21.1
Sex:Female
Location:Wisconsin
Vaccinated:1990-11-26
Onset:1990-12-03
Submitted:1990-12-12
Entered:1990-12-26 1990-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 1794F / 0 LA / SC

Administered by: Public      Purchased by: Unknown Public
Symptoms: Chills, Injection site mass, Pain, Pyrexia, Rash, CHILLS, FEVER, MASS INJECT SITE, RASH, PAIN

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: WBC-3.9, Segs-20, Bands-40, 45% atypical lymph
CDC 'Split Type': (blank) WI90055

Write-up: Pt c/o of chills all day, T103.6, arm had great deal of pain, developed a streaky rash on inside of lt arm, to body, arm became hard, red & swollen. Went to ER.


Changed on 2/14/2017

VAERS ID: 27145 Before After
VAERS Form:
Age:21.1 21.0
Sex:Female
Location:Wisconsin
Vaccinated:1990-11-26
Onset:1990-12-03
Submitted:1990-12-12
Entered:1990-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1794F / 0 LA / SC

Administered by: Public      Purchased by: Public
Symptoms: Chills, Injection site mass, Pain, Pyrexia, Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: WBC-3.9, Segs-20, Bands-40, 45% atypical lymph
CDC 'Split Type': WI90055

Write-up: Pt c/o of chills all day, T103.6, arm had great deal of pain, developed a streaky rash on inside of lt arm, to body, arm became hard, red & swollen. Went to ER.


Changed on 5/14/2017

VAERS ID: 27145 Before After
VAERS Form:
Age:21.0
Sex:Female
Location:Wisconsin
Vaccinated:1990-11-26
Onset:1990-12-03
Submitted:1990-12-12
Entered:1990-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1794F / 0 LA / SC

Administered by: Public      Purchased by: Public
Symptoms: Chills, Injection site mass, Pain, Pyrexia, Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: WBC-3.9, Segs-20, Bands-40, 45% atypical lymph
CDC 'Split Type': WI90055

Write-up: Pt c/o of chills all day, T103.6, arm had great deal of pain, developed a streaky rash on inside of lt arm, to body, arm became hard, red & swollen. Went to ER.


Changed on 9/14/2017

VAERS ID: 27145 Before After
VAERS Form:(blank) 1
Age:21.0
Sex:Female
Location:Wisconsin
Vaccinated:1990-11-26
Onset:1990-12-03
Submitted:1990-12-12
Entered:1990-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1794F / 0 1 LA / SC

Administered by: Public      Purchased by: Public
Symptoms: Chills, Injection site mass, Pain, Pyrexia, Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: WBC-3.9, Segs-20, Bands-40, 45% atypical lymph
CDC 'Split Type': WI90055

Write-up: Pt c/o of chills all day, T103.6, arm had great deal of pain, developed a streaky rash on inside of lt arm, to body, arm became hard, red & swollen. Went to ER.


Changed on 2/14/2018

VAERS ID: 27145 Before After
VAERS Form:1
Age:21.0
Sex:Female
Location:Wisconsin
Vaccinated:1990-11-26
Onset:1990-12-03
Submitted:1990-12-12
Entered:1990-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1794F / 1 LA / SC

Administered by: Public      Purchased by: Public
Symptoms: Chills, Injection site mass, Pain, Pyrexia, Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: WBC-3.9, Segs-20, Bands-40, 45% atypical lymph
CDC 'Split Type': WI90055

Write-up: Pt c/o of chills all day, T103.6, arm had great deal of pain, developed a streaky rash on inside of lt arm, to body, arm became hard, red & swollen. Went to ER.


Changed on 6/14/2018

VAERS ID: 27145 Before After
VAERS Form:1
Age:21.0
Sex:Female
Location:Wisconsin
Vaccinated:1990-11-26
Onset:1990-12-03
Submitted:1990-12-12
Entered:1990-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1794F / 1 LA / SC

Administered by: Public      Purchased by: Public
Symptoms: Chills, Injection site mass, Pain, Pyrexia, Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: WBC-3.9, Segs-20, Bands-40, 45% atypical lymph
CDC 'Split Type': WI90055

Write-up: Pt c/o of chills all day, T103.6, arm had great deal of pain, developed a streaky rash on inside of lt arm, to body, arm became hard, red & swollen. Went to ER.


Changed on 8/14/2018

VAERS ID: 27145 Before After
VAERS Form:1
Age:21.0
Sex:Female
Location:Wisconsin
Vaccinated:1990-11-26
Onset:1990-12-03
Submitted:1990-12-12
Entered:1990-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1794F / 1 LA / SC

Administered by: Public      Purchased by: Public
Symptoms: Chills, Injection site mass, Pain, Pyrexia, Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: WBC-3.9, Segs-20, Bands-40, 45% atypical lymph
CDC 'Split Type': WI90055

Write-up: Pt c/o of chills all day, T103.6, arm had great deal of pain, developed a streaky rash on inside of lt arm, to body, arm became hard, red & swollen. Went to ER.


Changed on 9/14/2018

VAERS ID: 27145 Before After
VAERS Form:1
Age:21.0
Sex:Female
Location:Wisconsin
Vaccinated:1990-11-26
Onset:1990-12-03
Submitted:1990-12-12
Entered:1990-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1794F / 1 LA / SC

Administered by: Public      Purchased by: Public
Symptoms: Chills, Injection site mass, Pain, Pyrexia, Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: WBC-3.9, Segs-20, Bands-40, 45% atypical lymph
CDC 'Split Type': WI90055

Write-up: Pt c/o of chills all day, T103.6, arm had great deal of pain, developed a streaky rash on inside of lt arm, to body, arm became hard, red & swollen. Went to ER.


Changed on 10/14/2018

VAERS ID: 27145 Before After
VAERS Form:1
Age:21.0
Sex:Female
Location:Wisconsin
Vaccinated:1990-11-26
Onset:1990-12-03
Submitted:1990-12-12
Entered:1990-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1794F / 1 LA / SC

Administered by: Public      Purchased by: Public
Symptoms: Chills, Injection site mass, Pain, Pyrexia, Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: WBC-3.9, Segs-20, Bands-40, 45% atypical lymph
CDC 'Split Type': WI90055

Write-up: Pt c/o of chills all day, T103.6, arm had great deal of pain, developed a streaky rash on inside of lt arm, to body, arm became hard, red & swollen. Went to ER.

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