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This is VAERS ID 25933

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 25933
VAERS Form:
Age:10.8
Sex:Female
Location:Illinois
Vaccinated:1990-08-28
Onset:1990-08-28
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: EDEMA FACE, PAIN, COUGH INC, LACRIMATION DIS, HYPERTENS

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? 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.


Changed on 12/8/2009

VAERS ID: 25933 Before After
VAERS Form:
Age:10.8
Sex:Female
Location:Illinois
Vaccinated:1990-08-28
Onset:1990-08-28
Submitted:0000-00-00
Entered:1990-09-19 1990-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
M: ATTENUVAX / MSD 1652R / 1 RA / SC
MEA: MEASLES (ATTENUVAX) / MERCK & CO. INC. 1652R / 1 RA / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Cough, Face oedema, Hypertension, Pain, Pruritus, Rhinitis, Lacrimal disorder, EDEMA FACE, PAIN, COUGH INC, LACRIMATION DIS, HYPERTENS

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? 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.


Changed on 2/14/2017

VAERS ID: 25933 Before After
VAERS Form:
Age:10.8 10.0
Sex:Female
Location:Illinois
Vaccinated:1990-08-28
Onset:1990-08-28
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, Pain, Pruritus, Rhinitis, Lacrimal disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? 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.


Changed on 5/14/2017

VAERS ID: 25933 Before After
VAERS Form:
Age:10.0
Sex:Female
Location:Illinois
Vaccinated:1990-08-28
Onset:1990-08-28
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, Pain, Pruritus, Rhinitis, Lacrimal disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? 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.


Changed on 9/14/2017

VAERS ID: 25933 Before After
VAERS Form:(blank) 1
Age:10.0
Sex:Female
Location:Illinois
Vaccinated:1990-08-28
Onset:1990-08-28
Submitted:0000-00-00
Entered:1990-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEA: MEASLES (ATTENUVAX) / MERCK & CO. INC. 1652R / 1 2 RA / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Cough, Face oedema, Hypertension, Pain, Pruritus, Rhinitis, Lacrimal disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? 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.


Changed on 2/14/2018

VAERS ID: 25933 Before After
VAERS Form:1
Age:10.0
Sex:Female
Location:Illinois
Vaccinated:1990-08-28
Onset:1990-08-28
Submitted:0000-00-00
Entered:1990-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEA: MEASLES (ATTENUVAX) / MERCK & CO. INC. 1652R / 2 RA / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Cough, Face oedema, Hypertension, Pain, Pruritus, Rhinitis, Lacrimal disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? 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.


Changed on 6/14/2018

VAERS ID: 25933 Before After
VAERS Form:1
Age:10.0
Sex:Female
Location:Illinois
Vaccinated:1990-08-28
Onset:1990-08-28
Submitted:0000-00-00
Entered:1990-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEA: MEASLES (ATTENUVAX) / MERCK & CO. INC. 1652R / 2 RA / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Cough, Face oedema, Hypertension, Pain, Pruritus, Rhinitis, Lacrimal disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? 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.


Changed on 8/14/2018

VAERS ID: 25933 Before After
VAERS Form:1
Age:10.0
Sex:Female
Location:Illinois
Vaccinated:1990-08-28
Onset:1990-08-28
Submitted:0000-00-00
Entered:1990-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEA: MEASLES (ATTENUVAX) / MERCK & CO. INC. 1652R / 2 RA / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Cough, Face oedema, Hypertension, Pain, Pruritus, Rhinitis, Lacrimal disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? 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.


Changed on 9/14/2018

VAERS ID: 25933 Before After
VAERS Form:1
Age:10.0
Sex:Female
Location:Illinois
Vaccinated:1990-08-28
Onset:1990-08-28
Submitted:0000-00-00
Entered:1990-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEA: MEASLES (ATTENUVAX) / MERCK & CO. INC. 1652R / 2 RA / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Cough, Face oedema, Hypertension, Pain, Pruritus, Rhinitis, Lacrimal disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? 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.


Changed on 10/14/2018

VAERS ID: 25933 Before After
VAERS Form:1
Age:10.0
Sex:Female
Location:Illinois
Vaccinated:1990-08-28
Onset:1990-08-28
Submitted:0000-00-00
Entered:1990-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEA: MEASLES (ATTENUVAX) / MERCK & CO. INC. 1652R / 2 RA / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Cough, Face oedema, Hypertension, Pain, Pruritus, Rhinitis, Lacrimal disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? 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.

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=25933&WAYBACKHISTORY=ON


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