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This is VAERS ID 33501

Case Details

VAERS ID: 33501 (history)  
Form: Version 1.0  
Age: 1.3  
Sex: Unknown  
Location: New Jersey  
Vaccinated:1987-03-11
Onset:1990-08-30
   Days after vaccination:1268
Submitted: 0000-00-00
Entered: 1991-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)

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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Unknown
Current Illness:
Preexisting Conditions: No relevant hx
Allergies:
Diagnostic Lab Data: No relevant data
CDC Split Type: WAES90100269

Write-up: 11Mar87 pt vax; 30Aug90 devel serologically confirmed measles & hospitalized.


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