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This is VAERS ID 27145

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

Case Details

VAERS ID: 27145 (history)  
Form: Version .0  
Age: 21.1  
Sex: Female  
Location: Wisconsin  
Vaccinated:1990-11-26
Onset:1990-12-03
   Days after vaccination:7
Submitted: 1990-12-12
   Days after onset:9
Entered: 1990-12-26
   Days after submission:14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II / MSD 1794F / 0 LA / SC

Administered by: Public       Purchased by: Unknown
Symptoms: CHILLS, FEVER, MASS INJECT SITE, PAIN, RASH
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? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: WBC-3.9, Segs-20, Bands-40, 45% atypical lymph
CDC Split Type:

Write-up: Pt c/o of chills all day, T103.6, arm had great deal of pain, developed a streaky rash on inside of lt arm, to body, arm became hard, red & swollen. Went to ER.


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=27145


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