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This is VAERS ID 26027

(NOTE: This result is from the 6/14/2018 version of the VAERS database)

Case Details

VAERS ID: 26027 (history)  
Form: Version 1.0  
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: 1990-09-21
   Days after submission:8
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH M030FC / UNK - / IM A
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1705S / 1 - / SC A

Administered by: Private       Purchased by: Public
Symptoms: Agitation, Anorexia, Injection site reaction, Rash, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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~ ()~~~In patient
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


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20180614&IDNUMBER=26027


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