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This is VAERS ID 26078

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

Case Details

VAERS ID: 26078 (history)  
Form: Version .0  
Age: 18.7  
Sex: Female  
Location: New York  
Vaccinated:1990-08-16
Onset:1990-08-16
   Days after vaccination:0
Submitted: 1990-09-17
   Days after onset:32
Entered: 1990-09-27
   Days after submission:10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II / MSD 0692S / 0 - / SC
TD: UNK.TD ADSORBED, ADULTS / UNCLASSIFIED 287962 / - A / -

Administered by: Private       Purchased by: Unknown
Symptoms: SYNCOPE
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:
Other Medications:
Current Illness:
Preexisting Conditions: Hx of prior syncope x2
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt vaccinated with MMR/TINE TEST 1 min later fainted sustained minor abrasions of face as result of syncope awoke spontaneously in 20 seconds after fainting.


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=26078


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