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This is VAERS ID 25933

(NOTE: This result is from the 12/31/2003 version of the VAERS database)

Case Details

VAERS ID: 25933 (history)  
Form: Version .0  
Age: 10.8  
Sex: Female  
Location: Illinois  
Vaccinated:1990-08-28
Onset:1990-08-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
M: ATTENUVAX / MSD 1652R / 1 RA / SC

Administered by: Private       Purchased by: Unknown
Symptoms: COUGH INC, EDEMA FACE, HYPERTENS, LACRIMATION DIS, PAIN
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: pt also rec''d PPD (Parke-Davis; lot 00550P; rt. forearm) at same time as vac.
Current Illness:
Preexisting Conditions: Strong hx of personal and family ataxia; No known egg allerg.
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt vaccinated with Measles Monovalent/PPD developed itchy, teary eyes with swollen lids,Nasal Congestion; Painful nose; Dry cough; Increased Diastolic pressure & Increased PR.


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=25933


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