VAERS ID: |
25933 (history) |
Form: |
Version .0 |
Age: |
10.0 |
Sex: |
Female |
Location: |
Illinois |
Vaccinated: | 1990-08-28 |
Onset: | 1990-08-28 |
Days after vaccination: | 0 |
Submitted: |
0000-00-00 |
Entered: |
1990-09-13 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
MEA: MEASLES (ATTENUVAX) / MERCK & CO. INC. |
1652R / 1 |
RA / SC |
Administered by: Private Purchased by: Unknown Symptoms: Cough,
Face oedema,
Hypertension,
Lacrimal disorder,
Pain,
Pruritus,
Rhinitis SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Hypertension (narrow), Lacrimal disorders (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? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient 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. |