This is VAERS ID 25485

Administered by: Private       Purchased by: Unknown
Symptoms: Hepatic function abnormal, Pyrexia, Rash maculo-papular, Vasculitis
SMQs:, Liver related investigations, signs and symptoms (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vasculitis (narrow), 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? Yes, ? days
   Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: no relevant hx
Allergies:
Diagnostic Lab Data: WBC- 37,700, platlets- 379,000, LDH- 1,000, SGOT- 50, sepsis work-up was neg. Additional lab data on WORM
CDC Split Type: WAES90031176

Write-up: 12 days/p vaccination, developed maculopapular rash on face, arms & legs. Became jumpy fussy, had fever 104 F- hospitalized, sysmtoms persisted for approx. 4 wks, subsequently rash became pigmented, DX as vasculitis