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This is VAERS ID 31184

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 31184
VAERS Form:
Age:1.6
Sex:Male
Location:Iowa
Vaccinated:1991-02-20
Onset:1991-02-21
Submitted:1991-06-07
Entered:1991-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II / MSD - / 0 - / -

Administered by: Private      Purchased by: Unknown
Symptoms: FEVER, INFECT, DEHYDRAT, OTITIS MED, CONJUNCTIVITIS

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data: No relevant data
CDC 'Split Type':

Write-up: Pt developed low grade temp & URI sx; To ER w/rash, otitis med & red eyelids w/conjunctival infect; tx Amoxicillin trihydrate (Augmentin); Pt hospitalized because of dehydration, temp of 102.3, s&s of measles;


Changed on 12/8/2009

VAERS ID: 31184 Before After
VAERS Form:
Age:1.6
Sex:Male
Location:Iowa
Vaccinated:1991-02-20
Onset:1991-02-21
Submitted:1991-06-07
Entered:1991-06-13 1991-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. - / 0 - / -

Administered by: Private      Purchased by: Unknown Private
Symptoms: Conjunctivitis, Dehydration, Infection, Otitis media, Pharyngitis, Pyrexia, Rash, FEVER, INFECT, DEHYDRAT, OTITIS MED, CONJUNCTIVITIS

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data: No relevant data
CDC 'Split Type': (blank) WAES91051867

Write-up: Pt developed low grade temp & URI sx; To ER w/rash, otitis med & red eyelids w/conjunctival infect; tx Amoxicillin trihydrate (Augmentin); Pt hospitalized because of dehydration, temp of 102.3, s&s of measles;


Changed on 5/14/2017

VAERS ID: 31184 Before After
VAERS Form:
Age:1.6
Sex:Male
Location:Iowa
Vaccinated:1991-02-20
Onset:1991-02-21
Submitted:1991-06-07
Entered:1991-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 0 - / -

Administered by: Private      Purchased by: Private
Symptoms: Conjunctivitis, Dehydration, Infection, Otitis media, Pharyngitis, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data: No relevant data
CDC 'Split Type': WAES91051867

Write-up: Pt developed low grade temp & URI sx; To ER w/rash, otitis med & red eyelids w/conjunctival infect; tx Amoxicillin trihydrate (Augmentin); Pt hospitalized because of dehydration, temp of 102.3, s&s of measles;


Changed on 9/14/2017

VAERS ID: 31184 Before After
VAERS Form:(blank) 1
Age:1.6
Sex:Male
Location:Iowa
Vaccinated:1991-02-20
Onset:1991-02-21
Submitted:1991-06-07
Entered:1991-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 0 1 - / -

Administered by: Private      Purchased by: Private
Symptoms: Conjunctivitis, Dehydration, Infection, Otitis media, Pharyngitis, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data: No relevant data
CDC 'Split Type': WAES91051867

Write-up: Pt developed low grade temp & URI sx; To ER w/rash, otitis med & red eyelids w/conjunctival infect; tx Amoxicillin trihydrate (Augmentin); Pt hospitalized because of dehydration, temp of 102.3, s&s of measles;


Changed on 2/14/2018

VAERS ID: 31184 Before After
VAERS Form:1
Age:1.6
Sex:Male
Location:Iowa
Vaccinated:1991-02-20
Onset:1991-02-21
Submitted:1991-06-07
Entered:1991-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 1 - / -

Administered by: Private      Purchased by: Private
Symptoms: Conjunctivitis, Dehydration, Infection, Otitis media, Pharyngitis, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data: No relevant data
CDC 'Split Type': WAES91051867

Write-up: Pt developed low grade temp & URI sx; To ER w/rash, otitis med & red eyelids w/conjunctival infect; tx Amoxicillin trihydrate (Augmentin); Pt hospitalized because of dehydration, temp of 102.3, s&s of measles;


Changed on 6/14/2018

VAERS ID: 31184 Before After
VAERS Form:1
Age:1.6
Sex:Male
Location:Iowa
Vaccinated:1991-02-20
Onset:1991-02-21
Submitted:1991-06-07
Entered:1991-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 1 - / -

Administered by: Private      Purchased by: Private
Symptoms: Conjunctivitis, Dehydration, Infection, Otitis media, Pharyngitis, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data: No relevant data
CDC 'Split Type': WAES91051867

Write-up: Pt developed low grade temp & URI sx; To ER w/rash, otitis med & red eyelids w/conjunctival infect; tx Amoxicillin trihydrate (Augmentin); Pt hospitalized because of dehydration, temp of 102.3, s&s of measles;


Changed on 8/14/2018

VAERS ID: 31184 Before After
VAERS Form:1
Age:1.6
Sex:Male
Location:Iowa
Vaccinated:1991-02-20
Onset:1991-02-21
Submitted:1991-06-07
Entered:1991-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 1 - / -

Administered by: Private      Purchased by: Private
Symptoms: Conjunctivitis, Dehydration, Infection, Otitis media, Pharyngitis, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data: No relevant data
CDC 'Split Type': WAES91051867

Write-up: Pt developed low grade temp & URI sx; To ER w/rash, otitis med & red eyelids w/conjunctival infect; tx Amoxicillin trihydrate (Augmentin); Pt hospitalized because of dehydration, temp of 102.3, s&s of measles;


Changed on 9/14/2018

VAERS ID: 31184 Before After
VAERS Form:1
Age:1.6
Sex:Male
Location:Iowa
Vaccinated:1991-02-20
Onset:1991-02-21
Submitted:1991-06-07
Entered:1991-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 1 - / -

Administered by: Private      Purchased by: Private
Symptoms: Conjunctivitis, Dehydration, Infection, Otitis media, Pharyngitis, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data: No relevant data
CDC 'Split Type': WAES91051867

Write-up: Pt developed low grade temp & URI sx; To ER w/rash, otitis med & red eyelids w/conjunctival infect; tx Amoxicillin trihydrate (Augmentin); Pt hospitalized because of dehydration, temp of 102.3, s&s of measles;


Changed on 10/14/2018

VAERS ID: 31184 Before After
VAERS Form:1
Age:1.6
Sex:Male
Location:Iowa
Vaccinated:1991-02-20
Onset:1991-02-21
Submitted:1991-06-07
Entered:1991-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 1 - / -

Administered by: Private      Purchased by: Private
Symptoms: Conjunctivitis, Dehydration, Infection, Otitis media, Pharyngitis, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data: No relevant data
CDC 'Split Type': WAES91051867

Write-up: Pt developed low grade temp & URI sx; To ER w/rash, otitis med & red eyelids w/conjunctival infect; tx Amoxicillin trihydrate (Augmentin); Pt hospitalized because of dehydration, temp of 102.3, s&s of measles;

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=31184&WAYBACKHISTORY=ON


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