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This is VAERS ID 28417

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 28417
VAERS Form:
Age:1.3
Sex:Female
Location:Georgia
Vaccinated:1991-01-28
Onset:1991-02-03
Submitted:1991-02-19
Entered:1991-02-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: UNK. HAEMOPHILUS B / UNCLASSIFIED 0C21132 / 0 - / -
MMR: MMR II / MSD 0560S / 0 - / -

Administered by: Private      Purchased by: Unknown
Symptoms: FEVER, ERYTHEMA MULT, PURPURA, LACRIMATION DIS, PETECHIA

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: 4     Extended hospital stay? No
Previous Vaccinations: none
Other Medications:
Current Illness: otitis media(?)
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: platelet count low 55,000
CDC 'Split Type': none

Write-up: Petechiae-$gpurpura, DX: Idiopathic thrombocytopenic purpura or erthema multiforme, had T of 101-102, runny eyes, measles type rash starting 1FEb con''t into above symptoms 2Feb /w purpura on 3Feb.


Changed on 12/8/2009

VAERS ID: 28417 Before After
VAERS Form:
Age:1.3
Sex:Female
Location:Georgia
Vaccinated:1991-01-28
Onset:1991-02-03
Submitted:1991-02-19
Entered:1991-02-28 1991-02-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: UNK. HAEMOPHILUS B HIB (NO BRAND NAME) / UNCLASSIFIED UNKNOWN MANUFACTURER 0C21132 / 0 - / -
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 0560S / 0 - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Erythema multiforme, Petechiae, Purpura, Pyrexia, Rash maculo-papular, Thrombocytopenia, Thrombocytopenic purpura, Lacrimal disorder, FEVER, ERYTHEMA MULT, PURPURA, LACRIMATION DIS, PETECHIA

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: 4     Extended hospital stay? No
Previous Vaccinations: none
Other Medications:
Current Illness: otitis media(?)
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: platelet count low 55,000
CDC 'Split Type': none (blank)

Write-up: Petechiae-$gpurpura, DX: Idiopathic thrombocytopenic purpura or erthema multiforme, had T of 101-102, runny eyes, measles type rash starting 1FEb con''t into above symptoms 2Feb /w purpura on 3Feb.


Changed on 5/14/2017

VAERS ID: 28417 Before After
VAERS Form:
Age:1.3
Sex:Female
Location:Georgia
Vaccinated:1991-01-28
Onset:1991-02-03
Submitted:1991-02-19
Entered:1991-02-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER 0C21132 / 0 - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0560S / 0 - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Erythema multiforme, Petechiae, Purpura, Pyrexia, Rash maculo-papular, Thrombocytopenia, Thrombocytopenic purpura, Lacrimal disorder

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: 4     Extended hospital stay? No
Previous Vaccinations: none none~ ()~~~In patient
Other Medications:
Current Illness: otitis media(?)
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: platelet count low 55,000
CDC 'Split Type':

Write-up: Petechiae-$gpurpura, DX: Idiopathic thrombocytopenic purpura or erthema multiforme, had T of 101-102, runny eyes, measles type rash starting 1FEb con''t into above symptoms 2Feb /w purpura on 3Feb.


Changed on 9/14/2017

VAERS ID: 28417 Before After
VAERS Form:(blank) 1
Age:1.3
Sex:Female
Location:Georgia
Vaccinated:1991-01-28
Onset:1991-02-03
Submitted:1991-02-19
Entered:1991-02-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER 0C21132 / 0 1 - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0560S / 0 1 - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Erythema multiforme, Petechiae, Purpura, Pyrexia, Rash maculo-papular, Thrombocytopenia, Thrombocytopenic purpura, Lacrimal disorder

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: 4     Extended hospital stay? No
Previous Vaccinations: none~ ()~~~In patient
Other Medications:
Current Illness: otitis media(?)
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: platelet count low 55,000
CDC 'Split Type':

Write-up: Petechiae-$gpurpura, DX: Idiopathic thrombocytopenic purpura or erthema multiforme, had T of 101-102, runny eyes, measles type rash starting 1FEb con''t into above symptoms 2Feb /w purpura on 3Feb.


Changed on 2/14/2018

VAERS ID: 28417 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Georgia
Vaccinated:1991-01-28
Onset:1991-02-03
Submitted:1991-02-19
Entered:1991-02-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER 0C21132 / 1 - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0560S / 1 - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Erythema multiforme, Petechiae, Purpura, Pyrexia, Rash maculo-papular, Thrombocytopenia, Thrombocytopenic purpura, Lacrimal disorder

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: 4     Extended hospital stay? No
Previous Vaccinations: none~ ()~~~In patient
Other Medications:
Current Illness: otitis media(?)
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: platelet count low 55,000
CDC 'Split Type':

Write-up: Petechiae-$gpurpura, DX: Idiopathic thrombocytopenic purpura or erthema multiforme, had T of 101-102, runny eyes, measles type rash starting 1FEb con''t into above symptoms 2Feb /w purpura on 3Feb.


Changed on 6/14/2018

VAERS ID: 28417 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Georgia
Vaccinated:1991-01-28
Onset:1991-02-03
Submitted:1991-02-19
Entered:1991-02-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER 0C21132 / 1 - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0560S / 1 - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Erythema multiforme, Petechiae, Purpura, Pyrexia, Rash maculo-papular, Thrombocytopenia, Thrombocytopenic purpura, Lacrimal disorder

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: 4     Extended hospital stay? No
Previous Vaccinations: none~ ()~~~In patient
Other Medications:
Current Illness: otitis media(?)
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: platelet count low 55,000
CDC 'Split Type':

Write-up: Petechiae-$gpurpura, DX: Idiopathic thrombocytopenic purpura or erthema multiforme, had T of 101-102, runny eyes, measles type rash starting 1FEb con''t into above symptoms 2Feb /w purpura on 3Feb.


Changed on 8/14/2018

VAERS ID: 28417 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Georgia
Vaccinated:1991-01-28
Onset:1991-02-03
Submitted:1991-02-19
Entered:1991-02-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER 0C21132 / 1 - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0560S / 1 - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Erythema multiforme, Petechiae, Purpura, Pyrexia, Rash maculo-papular, Thrombocytopenia, Thrombocytopenic purpura, Lacrimal disorder

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: 4     Extended hospital stay? No
Previous Vaccinations: none~ ()~~~In patient
Other Medications:
Current Illness: otitis media(?)
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: platelet count low 55,000
CDC 'Split Type':

Write-up: Petechiae-$gpurpura, DX: Idiopathic thrombocytopenic purpura or erthema multiforme, had T of 101-102, runny eyes, measles type rash starting 1FEb con''t into above symptoms 2Feb /w purpura on 3Feb.


Changed on 9/14/2018

VAERS ID: 28417 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Georgia
Vaccinated:1991-01-28
Onset:1991-02-03
Submitted:1991-02-19
Entered:1991-02-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER 0C21132 / 1 - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0560S / 1 - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Erythema multiforme, Petechiae, Purpura, Pyrexia, Rash maculo-papular, Thrombocytopenia, Thrombocytopenic purpura, Lacrimal disorder

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: 4     Extended hospital stay? No
Previous Vaccinations: none~ ()~~~In patient
Other Medications:
Current Illness: otitis media(?)
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: platelet count low 55,000
CDC 'Split Type':

Write-up: Petechiae-$gpurpura, DX: Idiopathic thrombocytopenic purpura or erthema multiforme, had T of 101-102, runny eyes, measles type rash starting 1FEb con''t into above symptoms 2Feb /w purpura on 3Feb.


Changed on 10/14/2018

VAERS ID: 28417 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Georgia
Vaccinated:1991-01-28
Onset:1991-02-03
Submitted:1991-02-19
Entered:1991-02-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER 0C21132 / 1 - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0560S / 1 - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Erythema multiforme, Petechiae, Purpura, Pyrexia, Rash maculo-papular, Thrombocytopenia, Thrombocytopenic purpura, Lacrimal disorder

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: 4     Extended hospital stay? No
Previous Vaccinations: none~ ()~~~In patient
Other Medications:
Current Illness: otitis media(?)
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: platelet count low 55,000
CDC 'Split Type':

Write-up: Petechiae-$gpurpura, DX: Idiopathic thrombocytopenic purpura or erthema multiforme, had T of 101-102, runny eyes, measles type rash starting 1FEb con''t into above symptoms 2Feb /w purpura on 3Feb.

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