National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 26004

(NOTE: This result is from the 9/14/2018 version of the VAERS database)

Case Details

VAERS ID: 26004 (history)  
Form: Version 1.0  
Age: 10.0  
Sex: Female  
Location: Illinois  
Vaccinated:1990-09-12
Onset:1990-09-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0438S / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Asthma, Dyspnoea, Face oedema
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), 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: Pt recvd MMR vax in past /w no allergic response~ ()~~~In patient
Other Medications: TB skin test 12Sep90
Current Illness:
Preexisting Conditions: no hx of dru allergies,
Allergies:
Diagnostic Lab Data: Admission VS BP 112/62, T 98.9, P 114, R 22
CDC Split Type:

Write-up: Immed /p adm of MMR vax, pt developed SOB, wheezing & angioedema (swollen eyes & nasal edema) Pt was adm Epinephrine /w positive results, transported via ambulance to ER & recvd Diphenhydramine & ice packs applied to eyes


New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20180914&IDNUMBER=26004


Copyright © 2020 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166