VAERS ID: |
25792 (history) |
Form: |
Version 1.0 |
Age: |
19.0 |
Sex: |
Female |
Location: |
Pennsylvania |
Vaccinated: | 1990-08-07 |
Onset: | 1990-08-07 |
Days after vaccination: | 0 |
Submitted: |
0000-00-00 |
Entered: |
1990-08-28 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. |
10215 / UNK |
- / IM |
Administered by: Private Purchased by: Unknown Symptoms: Arthralgia,
Osteoarthritis,
Rash SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Arthritis (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? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: Lyme test - negative CDC Split Type:
Write-up: Rash on arm, joints swollen, aches. |