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This is VAERS ID 37291

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 37291
VAERS Form:
Age:1.3
Sex:Male
Location:New Jersey
Vaccinated:1987-07-16
Onset:1991-01-27
Submitted:0000-00-00
Entered:1992-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II / MSD - / 0 - / -

Administered by: Private      Purchased by: Unknown
Symptoms: FEVER, INFECT, FLU SYND, CONJUNCTIVITIS, OLIGURIA

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: 7     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 9FEB91 IgG .04;
CDC 'Split Type':

Write-up: Pt recvd MMR vax on 16JUL87 & on 27JAN91 pt had t102 secondary to OM; pt devel congestion & mough ulcers dx viral flu; 31JAN91 devel diarrhea, was lethargic & had red eyes; pt had not urinated for a couple of days; pt hospitalized;


Changed on 12/8/2009

VAERS ID: 37291 Before After
VAERS Form:
Age:1.3
Sex:Male
Location:New Jersey
Vaccinated:1987-07-16
Onset:1991-01-27
Submitted:0000-00-00
Entered:1992-07-21 1992-06-09
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, Infection, Influenza, Mouth ulceration, Oliguria, Otitis media, Pyrexia, Rhinitis, FEVER, INFECT, FLU SYND, CONJUNCTIVITIS, OLIGURIA

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: 7     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 9FEB91 IgG .04;
CDC 'Split Type': (blank) WAES91050994

Write-up: Pt recvd MMR vax on 16JUL87 & on 27JAN91 pt had t102 secondary to OM; pt devel congestion & mough ulcers dx viral flu; 31JAN91 devel diarrhea, was lethargic & had red eyes; pt had not urinated for a couple of days; pt hospitalized;


Changed on 5/14/2017

VAERS ID: 37291 Before After
VAERS Form:
Age:1.3
Sex:Male
Location:New Jersey
Vaccinated:1987-07-16
Onset:1991-01-27
Submitted:0000-00-00
Entered:1992-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 0 - / -

Administered by: Private      Purchased by: Private
Symptoms: Conjunctivitis, Infection, Influenza, Mouth ulceration, Oliguria, Otitis media, Pyrexia, Rhinitis

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: 7     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 9FEB91 IgG .04;
CDC 'Split Type': WAES91050994

Write-up: Pt recvd MMR vax on 16JUL87 & on 27JAN91 pt had t102 secondary to OM; pt devel congestion & mough ulcers dx viral flu; 31JAN91 devel diarrhea, was lethargic & had red eyes; pt had not urinated for a couple of days; pt hospitalized;


Changed on 9/14/2017

VAERS ID: 37291 Before After
VAERS Form:(blank) 1
Age:1.3
Sex:Male
Location:New Jersey
Vaccinated:1987-07-16
Onset:1991-01-27
Submitted:0000-00-00
Entered:1992-06-09
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, Infection, Influenza, Mouth ulceration, Oliguria, Otitis media, Pyrexia, Rhinitis

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: 7     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 9FEB91 IgG .04;
CDC 'Split Type': WAES91050994

Write-up: Pt recvd MMR vax on 16JUL87 & on 27JAN91 pt had t102 secondary to OM; pt devel congestion & mough ulcers dx viral flu; 31JAN91 devel diarrhea, was lethargic & had red eyes; pt had not urinated for a couple of days; pt hospitalized;


Changed on 2/14/2018

VAERS ID: 37291 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:New Jersey
Vaccinated:1987-07-16
Onset:1991-01-27
Submitted:0000-00-00
Entered:1992-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 1 - / -

Administered by: Private      Purchased by: Private
Symptoms: Conjunctivitis, Infection, Influenza, Mouth ulceration, Oliguria, Otitis media, Pyrexia, Rhinitis

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: 7     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 9FEB91 IgG .04;
CDC 'Split Type': WAES91050994

Write-up: Pt recvd MMR vax on 16JUL87 & on 27JAN91 pt had t102 secondary to OM; pt devel congestion & mough ulcers dx viral flu; 31JAN91 devel diarrhea, was lethargic & had red eyes; pt had not urinated for a couple of days; pt hospitalized;


Changed on 6/14/2018

VAERS ID: 37291 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:New Jersey
Vaccinated:1987-07-16
Onset:1991-01-27
Submitted:0000-00-00
Entered:1992-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 1 - / -

Administered by: Private      Purchased by: Private
Symptoms: Conjunctivitis, Infection, Influenza, Mouth ulceration, Oliguria, Otitis media, Pyrexia, Rhinitis

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: 7     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 9FEB91 IgG .04;
CDC 'Split Type': WAES91050994

Write-up: Pt recvd MMR vax on 16JUL87 & on 27JAN91 pt had t102 secondary to OM; pt devel congestion & mough ulcers dx viral flu; 31JAN91 devel diarrhea, was lethargic & had red eyes; pt had not urinated for a couple of days; pt hospitalized;


Changed on 8/14/2018

VAERS ID: 37291 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:New Jersey
Vaccinated:1987-07-16
Onset:1991-01-27
Submitted:0000-00-00
Entered:1992-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 1 - / -

Administered by: Private      Purchased by: Private
Symptoms: Conjunctivitis, Infection, Influenza, Mouth ulceration, Oliguria, Otitis media, Pyrexia, Rhinitis

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: 7     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 9FEB91 IgG .04;
CDC 'Split Type': WAES91050994

Write-up: Pt recvd MMR vax on 16JUL87 & on 27JAN91 pt had t102 secondary to OM; pt devel congestion & mough ulcers dx viral flu; 31JAN91 devel diarrhea, was lethargic & had red eyes; pt had not urinated for a couple of days; pt hospitalized;


Changed on 9/14/2018

VAERS ID: 37291 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:New Jersey
Vaccinated:1987-07-16
Onset:1991-01-27
Submitted:0000-00-00
Entered:1992-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 1 - / -

Administered by: Private      Purchased by: Private
Symptoms: Conjunctivitis, Infection, Influenza, Mouth ulceration, Oliguria, Otitis media, Pyrexia, Rhinitis

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: 7     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 9FEB91 IgG .04;
CDC 'Split Type': WAES91050994

Write-up: Pt recvd MMR vax on 16JUL87 & on 27JAN91 pt had t102 secondary to OM; pt devel congestion & mough ulcers dx viral flu; 31JAN91 devel diarrhea, was lethargic & had red eyes; pt had not urinated for a couple of days; pt hospitalized;


Changed on 10/14/2018

VAERS ID: 37291 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:New Jersey
Vaccinated:1987-07-16
Onset:1991-01-27
Submitted:0000-00-00
Entered:1992-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 1 - / -

Administered by: Private      Purchased by: Private
Symptoms: Conjunctivitis, Infection, Influenza, Mouth ulceration, Oliguria, Otitis media, Pyrexia, Rhinitis

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: 7     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 9FEB91 IgG .04;
CDC 'Split Type': WAES91050994

Write-up: Pt recvd MMR vax on 16JUL87 & on 27JAN91 pt had t102 secondary to OM; pt devel congestion & mough ulcers dx viral flu; 31JAN91 devel diarrhea, was lethargic & had red eyes; pt had not urinated for a couple of days; pt hospitalized;

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=37291&WAYBACKHISTORY=ON


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