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This is VAERS ID 31184

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

Case Details

VAERS ID: 31184 (history)  
Form: Version .0  
Age: 1.6  
Sex: Male  
Location: Iowa  
Vaccinated:1991-02-20
Onset:1991-02-21
   Days after vaccination:1
Submitted: 1991-06-07
   Days after onset:105
Entered: 1991-06-13
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II / MSD - / 0 - / -

Administered by: Private       Purchased by: Unknown
Symptoms: CONJUNCTIVITIS, DEHYDRAT, FEVER, INFECT, OTITIS MED
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data: No relevant data
CDC Split Type:

Write-up: Pt developed low grade temp & URI sx; To ER w/rash, otitis med & red eyelids w/conjunctival infect; tx Amoxicillin trihydrate (Augmentin); Pt hospitalized because of dehydration, temp of 102.3, s&s of measles;


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