National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 26317

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 26317
VAERS Form:
Age:5.2
Sex:Female
Location:New York
Vaccinated:1990-10-10
Onset:1990-10-10
Submitted:1990-10-18
Entered:1990-10-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP / CONNAUGHT LABS 0A21149 / 4 A / IM
MMR: MMR II / MSD 1313S / 1 A / IM

Administered by: Public      Purchased by: Unknown
Symptoms: RHINITIS, ASTHMA, URTICARIA, ALLERG REACT, COUGH INC

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Current Illness: Anaphalaxis type rxn @ time of vacc.
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated /w DTP/MMR developed acute allergic rxn involving diffuse urticaria, rhinonlea, sneezing, cough & wheezing within 60 sec of inject. Pt required Epinephrine & Diphenydramine inject.


Changed on 12/8/2009

VAERS ID: 26317 Before After
VAERS Form:
Age:5.2
Sex:Female
Location:New York
Vaccinated:1990-10-10
Onset:1990-10-10
Submitted:1990-10-18
Entered:1990-10-31 1990-10-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP DTP (NO BRAND NAME) / CONNAUGHT LABS CONNAUGHT LABORATORIES 0A21149 / 4 A / IM
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 1313S / 1 A / IM

Administered by: Public      Purchased by: Unknown Public
Symptoms: Asthma, Cough, Hypersensitivity, Rhinitis, Urticaria, RHINITIS, ASTHMA, URTICARIA, ALLERG REACT, COUGH INC

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Current Illness: Anaphalaxis type rxn @ time of vacc.
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated /w DTP/MMR developed acute allergic rxn involving diffuse urticaria, rhinonlea, sneezing, cough & wheezing within 60 sec of inject. Pt required Epinephrine & Diphenydramine inject.


Changed on 2/14/2017

VAERS ID: 26317 Before After
VAERS Form:
Age:5.2 5.0
Sex:Female
Location:New York
Vaccinated:1990-10-10
Onset:1990-10-10
Submitted:1990-10-18
Entered:1990-10-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0A21149 / 4 A / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1313S / 1 A / IM

Administered by: Public      Purchased by: Public
Symptoms: Asthma, Cough, Hypersensitivity, Rhinitis, Urticaria

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Current Illness: Anaphalaxis type rxn @ time of vacc.
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated /w DTP/MMR developed acute allergic rxn involving diffuse urticaria, rhinonlea, sneezing, cough & wheezing within 60 sec of inject. Pt required Epinephrine & Diphenydramine inject.


Changed on 5/14/2017

VAERS ID: 26317 Before After
VAERS Form:
Age:5.0
Sex:Female
Location:New York
Vaccinated:1990-10-10
Onset:1990-10-10
Submitted:1990-10-18
Entered:1990-10-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0A21149 / 4 A - / IM IM A
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1313S / 1 A - / IM IM A

Administered by: Public      Purchased by: Public
Symptoms: Asthma, Cough, Hypersensitivity, Rhinitis, Urticaria

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Current Illness: Anaphalaxis type rxn @ time of vacc.
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated /w DTP/MMR developed acute allergic rxn involving diffuse urticaria, rhinonlea, sneezing, cough & wheezing within 60 sec of inject. Pt required Epinephrine & Diphenydramine inject.


Changed on 9/14/2017

VAERS ID: 26317 Before After
VAERS Form:(blank) 1
Age:5.0
Sex:Female
Location:New York
Vaccinated:1990-10-10
Onset:1990-10-10
Submitted:1990-10-18
Entered:1990-10-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0A21149 / 4 5 - / IM A
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1313S / 1 2 - / IM A

Administered by: Public      Purchased by: Public
Symptoms: Asthma, Cough, Hypersensitivity, Rhinitis, Urticaria

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Current Illness: Anaphalaxis type rxn @ time of vacc.
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated /w DTP/MMR developed acute allergic rxn involving diffuse urticaria, rhinonlea, sneezing, cough & wheezing within 60 sec of inject. Pt required Epinephrine & Diphenydramine inject.


Changed on 2/14/2018

VAERS ID: 26317 Before After
VAERS Form:1
Age:5.0
Sex:Female
Location:New York
Vaccinated:1990-10-10
Onset:1990-10-10
Submitted:1990-10-18
Entered:1990-10-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0A21149 / 5 - / IM A
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1313S / 2 - / IM A

Administered by: Public      Purchased by: Public
Symptoms: Asthma, Cough, Hypersensitivity, Rhinitis, Urticaria

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Current Illness: Anaphalaxis type rxn @ time of vacc.
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated /w DTP/MMR developed acute allergic rxn involving diffuse urticaria, rhinonlea, sneezing, cough & wheezing within 60 sec of inject. Pt required Epinephrine & Diphenydramine inject.


Changed on 6/14/2018

VAERS ID: 26317 Before After
VAERS Form:1
Age:5.0
Sex:Female
Location:New York
Vaccinated:1990-10-10
Onset:1990-10-10
Submitted:1990-10-18
Entered:1990-10-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0A21149 / 5 - / IM A
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1313S / 2 - / IM A

Administered by: Public      Purchased by: Public
Symptoms: Asthma, Cough, Hypersensitivity, Rhinitis, Urticaria

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Current Illness: Anaphalaxis type rxn @ time of vacc.
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated /w DTP/MMR developed acute allergic rxn involving diffuse urticaria, rhinonlea, sneezing, cough & wheezing within 60 sec of inject. Pt required Epinephrine & Diphenydramine inject.


Changed on 8/14/2018

VAERS ID: 26317 Before After
VAERS Form:1
Age:5.0
Sex:Female
Location:New York
Vaccinated:1990-10-10
Onset:1990-10-10
Submitted:1990-10-18
Entered:1990-10-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0A21149 / 5 - / IM A
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1313S / 2 - / IM A

Administered by: Public      Purchased by: Public
Symptoms: Asthma, Cough, Hypersensitivity, Rhinitis, Urticaria

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Current Illness: Anaphalaxis type rxn @ time of vacc.
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated /w DTP/MMR developed acute allergic rxn involving diffuse urticaria, rhinonlea, sneezing, cough & wheezing within 60 sec of inject. Pt required Epinephrine & Diphenydramine inject.


Changed on 9/14/2018

VAERS ID: 26317 Before After
VAERS Form:1
Age:5.0
Sex:Female
Location:New York
Vaccinated:1990-10-10
Onset:1990-10-10
Submitted:1990-10-18
Entered:1990-10-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0A21149 / 5 - / IM A
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1313S / 2 - / IM A

Administered by: Public      Purchased by: Public
Symptoms: Asthma, Cough, Hypersensitivity, Rhinitis, Urticaria

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Current Illness: Anaphalaxis type rxn @ time of vacc.
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated /w DTP/MMR developed acute allergic rxn involving diffuse urticaria, rhinonlea, sneezing, cough & wheezing within 60 sec of inject. Pt required Epinephrine & Diphenydramine inject.


Changed on 10/14/2018

VAERS ID: 26317 Before After
VAERS Form:1
Age:5.0
Sex:Female
Location:New York
Vaccinated:1990-10-10
Onset:1990-10-10
Submitted:1990-10-18
Entered:1990-10-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0A21149 / 5 - / IM A
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1313S / 2 - / IM A

Administered by: Public      Purchased by: Public
Symptoms: Asthma, Cough, Hypersensitivity, Rhinitis, Urticaria

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Current Illness: Anaphalaxis type rxn @ time of vacc.
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated /w DTP/MMR developed acute allergic rxn involving diffuse urticaria, rhinonlea, sneezing, cough & wheezing within 60 sec of inject. Pt required Epinephrine & Diphenydramine inject.


Changed on 12/24/2020

VAERS ID: 26317 Before After
VAERS Form:1
Age:5.0
Sex:Female
Location:New York
Vaccinated:1990-10-10
Onset:1990-10-10
Submitted:1990-10-18
Entered:1990-10-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0A21149 / 5 - / IM A
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1313S / 2 - / IM A

Administered by: Public      Purchased by: Public
Symptoms: Asthma, Cough, Hypersensitivity, Rhinitis, Urticaria

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Current Illness: Anaphalaxis type rxn @ time of vacc.
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated /w DTP/MMR developed acute allergic rxn involving diffuse urticaria, rhinonlea, sneezing, cough & wheezing within 60 sec of inject. Pt required Epinephrine & Diphenydramine inject.


Changed on 12/30/2020

VAERS ID: 26317 Before After
VAERS Form:1
Age:5.0
Sex:Female
Location:New York
Vaccinated:1990-10-10
Onset:1990-10-10
Submitted:1990-10-18
Entered:1990-10-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0A21149 / 5 - / IM A
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1313S / 2 - / IM A

Administered by: Public      Purchased by: Public
Symptoms: Asthma, Cough, Hypersensitivity, Rhinitis, Urticaria

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Current Illness: Anaphalaxis type rxn @ time of vacc.
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated /w DTP/MMR developed acute allergic rxn involving diffuse urticaria, rhinonlea, sneezing, cough & wheezing within 60 sec of inject. Pt required Epinephrine & Diphenydramine inject.

New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=26317&WAYBACKHISTORY=ON


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166