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This is VAERS ID 27815

Case Details

VAERS ID: 27815 (history)  
Form: Version 1.0  
Age: 1.3  
Sex: Male  
Location: Michigan  
Vaccinated:1991-01-25
Onset:1991-01-29
   Days after vaccination:4
Submitted: 1991-01-31
   Days after onset:2
Entered: 1991-02-08
   Days after submission:8
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1921S / 1 - / IM

Administered by: Private       Purchased by: Private
Symptoms: Ecchymosis, Petechiae, Thrombocytopenia
SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (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? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CBC: platelets less than 10,000
CDC Split Type:

Write-up: Thrombocytopenia, cause petechiae all over the body, ecchymosis on tibia 5 days post vax. Referred to hosp.


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