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This is VAERS ID 61633

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

Case Details

VAERS ID: 61633 (history)  
Form: Version .0  
Age: 10.0  
Sex: Male  
Location: Maryland  
Vaccinated:1993-11-16
Onset:1993-11-18
   Days after vaccination:2
Submitted: 1994-04-04
   Days after onset:136
Entered: 1994-04-11
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II / MSD 1144W / 1 - / -

Administered by: Other       Purchased by: Unknown
Symptoms: DYSURIA, HYSTERIA, PAIN ABDO, PAIN BONE, PAIN PELVIC
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 27NOV93 WBC 6300; Lymphocytes 44%; Granulocytes 56%; UA nl; Ultrasound nl; 30NOV93 urine culture neg;
CDC Split Type:

Write-up: Pt recvd vax 16NOV93 & 18NOV93 exp abdo pain, penile pain, urinary frequency & burning; Pt was seen by MD; UA was WNL; 27NOV93 pt was seen again by MD w/cont pain upon urination which radiated into testicles & pubic bone, cloudy urine;


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=61633


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