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This is VAERS ID 31050

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

Case Details

VAERS ID: 31050 (history)  
Form: Version .0  
Age: 1.3  
Sex: Female  
Location: Kansas  
Vaccinated:1991-03-22
Onset:1991-03-31
   Days after vaccination:9
Submitted: 1991-04-04
   Days after onset:4
Entered: 1991-06-10
   Days after submission:66
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II / MSD 0555S / 0 LL / -

Administered by: Public       Purchased by: Unknown
Symptoms: EDEMA FACE, FEVER, RHINITIS, STUPOR
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: NONE
Other Medications: Rondec
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CXR
CDC Split Type: NONE

Write-up: t99-100, congestion, swollen, mattery eyes 2-3 days prior to becoming non-responsive; taken to hosp & given oxygen, suctioned & breathing tx; given antibiotic, IV fluids, & APAP suppositories;


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=31050


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