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This is VAERS ID 25484

(NOTE: This result is from the 1/7/2013 version of the VAERS database)

Case Details

VAERS ID: 25484 (history)  
Form: Version .0  
Age: 1.5  
Sex: Female  
Location: New York  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 1990-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 40967/2130R / - - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Pyrexia, Rash maculo-papular, Vasculitis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vasculitis (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:
CDC Split Type: WAES90040110

Write-up: 18month-old vaccinated w/MMR eighteen days after vaccination she developed a fever of 104 and macular rash of the face, torso & legs. The symptoms remitted spontaneously, recurred 2 wks later described as vasculitis. No further details.


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