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This is VAERS ID 27688

Case Details

VAERS ID: 27688 (history)  
Form: Version 1.0  
Age: 35.0  
Sex: Male  
Location: New York  
Vaccinated:1991-01-02
Onset:1991-01-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1991-01-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1336S / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Hypersensitivity, Myasthenic syndrome, Pain
SMQs:, Angioedema (broad), Malignancy related conditions (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: WAES91010511

Write-up: pt had pain in arms & muscle weakness in arms & legs. 4Jan91 hospitalized to R/O GBS. Neuro consult revealed pt did not have GBS & was D/C 7Jan91. MD felt sxs d/t vaccination w/ MMR.


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