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This is VAERS ID 31164

Case Details

VAERS ID: 31164 (history)  
Form: Version 1.0  
Age: 0.1  
Sex: Female  
Location: California  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 1991-04-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (FOREIGN) / MERCK & CO. INC. - / 2 - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Erythema multiforme, Rash
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Hypersensitivity (narrow), 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? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: UNK
Current Illness:
Preexisting Conditions: No relevant hx
Allergies:
Diagnostic Lab Data: No relevant data
CDC Split Type: WAES90041041

Write-up: Two wks following 2nd vax pt developed rash w/target lesions; Dx of erythema multiforme was made; @ time of report the lesions had largly resolved;


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