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This is VAERS ID 31149

Case Details

VAERS ID: 31149 (history)  
Form: Version 1.0  
Age: 1.5  
Sex: Unknown  
Location: New York  
Vaccinated:0000-00-00
Onset:1991-06-06
Submitted: 1991-06-06
   Days after onset:0
Entered: 1991-06-10
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 2 - / -

Administered by: Other       Purchased by: Other
Symptoms: Rheumatoid arthritis
SMQs:, Arthritis (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: No relevant data
CDC Split Type: WAES91051729

Write-up: Pt developed severe systemic juvenile rheumatoid arthritis seven months p/vax w/MMR;


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