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This is VAERS ID 27145

(NOTE: This result is from the 5/14/2017 version of the VAERS database)

Case Details

VAERS ID: 27145 (history)  
Form: Version .0  
Age: 21.0  
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: 1990-12-21
   Days after submission:9
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1794F / 0 LA / SC

Administered by: Public       Purchased by: Public
Symptoms: Chills, Injection site mass, Pain, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: WBC-3.9, Segs-20, Bands-40, 45% atypical lymph
CDC Split Type: WI90055

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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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20170514&IDNUMBER=27145


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