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This is VAERS ID 61633

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 61633
VAERS Form:
Age:10.0
Sex:Male
Location:Maryland
Vaccinated:1993-11-16
Onset:1993-11-18
Submitted:1994-04-04
Entered:1994-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II / MSD 1144W / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? 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;


Changed on 12/8/2009

VAERS ID: 61633 Before After
VAERS Form:
Age:10.0
Sex:Male
Location:Maryland
Vaccinated:1993-11-16
Onset:1993-11-18
Submitted:1994-04-04
Entered:1994-04-11 1994-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 1144W / 1 - / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Abdominal pain, Bone pain, Conversion disorder, Dysuria, Pelvic pain, Pollakiuria, Urine analysis abnormal, PAIN PELVIC, PAIN ABDO, DYSURIA, HYSTERIA, PAIN BONE

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? 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': (blank) WAES93120809

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;


Changed on 5/14/2017

VAERS ID: 61633 Before After
VAERS Form:
Age:10.0
Sex:Male
Location:Maryland
Vaccinated:1993-11-16
Onset:1993-11-18
Submitted:1994-04-04
Entered:1994-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1144W / 1 - / -

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Bone pain, Conversion disorder, Dysuria, Pelvic pain, Pollakiuria, Urine analysis abnormal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
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': WAES93120809

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;


Changed on 9/14/2017

VAERS ID: 61633 Before After
VAERS Form:(blank) 1
Age:10.0
Sex:Male
Location:Maryland
Vaccinated:1993-11-16
Onset:1993-11-18
Submitted:1994-04-04
Entered:1994-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1144W / 1 2 - / -

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Bone pain, Conversion disorder, Dysuria, Pelvic pain, Pollakiuria, Urine analysis abnormal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
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': WAES93120809

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;


Changed on 2/14/2018

VAERS ID: 61633 Before After
VAERS Form:1
Age:10.0
Sex:Male
Location:Maryland
Vaccinated:1993-11-16
Onset:1993-11-18
Submitted:1994-04-04
Entered:1994-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1144W / 2 - / -

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Bone pain, Conversion disorder, Dysuria, Pelvic pain, Pollakiuria, Urine analysis abnormal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
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': WAES93120809

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;


Changed on 6/14/2018

VAERS ID: 61633 Before After
VAERS Form:1
Age:10.0
Sex:Male
Location:Maryland
Vaccinated:1993-11-16
Onset:1993-11-18
Submitted:1994-04-04
Entered:1994-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1144W / 2 - / -

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Bone pain, Conversion disorder, Dysuria, Pelvic pain, Pollakiuria, Urine analysis abnormal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
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': WAES93120809

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;


Changed on 8/14/2018

VAERS ID: 61633 Before After
VAERS Form:1
Age:10.0
Sex:Male
Location:Maryland
Vaccinated:1993-11-16
Onset:1993-11-18
Submitted:1994-04-04
Entered:1994-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1144W / 2 - / -

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Bone pain, Conversion disorder, Dysuria, Pelvic pain, Pollakiuria, Urine analysis abnormal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
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': WAES93120809

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;


Changed on 9/14/2018

VAERS ID: 61633 Before After
VAERS Form:1
Age:10.0
Sex:Male
Location:Maryland
Vaccinated:1993-11-16
Onset:1993-11-18
Submitted:1994-04-04
Entered:1994-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1144W / 2 - / -

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Bone pain, Conversion disorder, Dysuria, Pelvic pain, Pollakiuria, Urine analysis abnormal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
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': WAES93120809

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;


Changed on 10/14/2018

VAERS ID: 61633 Before After
VAERS Form:1
Age:10.0
Sex:Male
Location:Maryland
Vaccinated:1993-11-16
Onset:1993-11-18
Submitted:1994-04-04
Entered:1994-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1144W / 2 - / -

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Bone pain, Conversion disorder, Dysuria, Pelvic pain, Pollakiuria, Urine analysis abnormal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
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': WAES93120809

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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