National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 26027

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

Case Details

VAERS ID: 26027 (history)  
Form: Version .0  
Age: 1.4  
Sex: Male  
Location: Illinois  
Vaccinated:1990-09-12
Onset:1990-09-12
   Days after vaccination:0
Submitted: 1990-09-13
   Days after onset:1
Entered: 1990-09-25
   Days after submission:12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIBTITER / LEDERLE(PRAXIS) M030FC / - A / IM
MMR: MMR II / MSD 1705S / 0 A / SC

Administered by: Private       Purchased by: Unknown
Symptoms: AGITATION, ANOREXIA, INJECT SITE REACT, RASH, VOMIT
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: no previous reaction
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Shot lt arm red, the day /p red streak from shot to elbow, throwing up. Won''t eat or anything. Real cranky, erythematous skin, Rxn to MMR


New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=26027


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