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This is VAERS ID 83750

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 83750
VAERS Form:
Age:16.9
Sex:Male
Location:South Carolina
Vaccinated:1996-02-28
Onset:1996-02-28
Submitted:1996-02-29
Entered:1996-03-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II / MSD 0619B / 1 - / SC
TD: TD ADSORBED, ADULTS / LEDERLE 398904 / 4 - / IM

Administered by: Public      Purchased by: Unknown
Symptoms: URTICARIA

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: pt exp rxn in 1994 w/measles dose 2
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': NONE

Write-up: father & stepmom states pt devel welts all over body (systemic rxn) by 4PM on the afternoon inj given;past records indicated a measles vax given in 1983 & father states had no rxn from inj;pt wasn''t taken to MD;


Changed on 12/8/2009

VAERS ID: 83750 Before After
VAERS Form:
Age:16.9
Sex:Male
Location:South Carolina
Vaccinated:1996-02-28
Onset:1996-02-28
Submitted:1996-02-29
Entered:1996-03-21 1996-03-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 0619B / 1 - / SC
TD: TD ADSORBED, ADULTS TD ADSORBED (NO BRAND NAME) / LEDERLE LEDERLE LABORATORIES 398904 / 4 - / IM

Administered by: Public      Purchased by: Unknown Public
Symptoms: Urticaria, URTICARIA

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: pt exp rxn in 1994 w/measles dose 2
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': NONE SC96011

Write-up: father & stepmom states pt devel welts all over body (systemic rxn) by 4PM on the afternoon inj given;past records indicated a measles vax given in 1983 & father states had no rxn from inj;pt wasn''t taken to MD;


Changed on 2/14/2017

VAERS ID: 83750 Before After
VAERS Form:
Age:16.9 16.0
Sex:Male
Location:South Carolina
Vaccinated:1996-02-28
Onset:1996-02-28
Submitted:1996-02-29
Entered:1996-03-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0619B / 1 - / SC
TD: TD ADSORBED (NO BRAND NAME) / LEDERLE LABORATORIES 398904 / 4 - / IM

Administered by: Public      Purchased by: Public
Symptoms: Urticaria

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: pt exp rxn in 1994 w/measles dose 2
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': SC96011

Write-up: father & stepmom states pt devel welts all over body (systemic rxn) by 4PM on the afternoon inj given;past records indicated a measles vax given in 1983 & father states had no rxn from inj;pt wasn''t taken to MD;


Changed on 5/14/2017

VAERS ID: 83750 Before After
VAERS Form:
Age:16.0
Sex:Male
Location:South Carolina
Vaccinated:1996-02-28
Onset:1996-02-28
Submitted:1996-02-29
Entered:1996-03-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0619B / 1 - / SC
TD: TD ADSORBED (NO BRAND NAME) / LEDERLE LABORATORIES 398904 / 4 - / IM

Administered by: Public      Purchased by: Public
Symptoms: Urticaria

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: pt exp rxn in 1994 w/measles dose 2 2~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': SC96011

Write-up: father & stepmom states pt devel welts all over body (systemic rxn) by 4PM on the afternoon inj given;past records indicated a measles vax given in 1983 & father states had no rxn from inj;pt wasn''t taken to MD;


Changed on 9/14/2017

VAERS ID: 83750 Before After
VAERS Form:(blank) 1
Age:16.0
Sex:Male
Location:South Carolina
Vaccinated:1996-02-28
Onset:1996-02-28
Submitted:1996-02-29
Entered:1996-03-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0619B / 1 2 - / SC
TD: TD ADSORBED (NO BRAND NAME) / LEDERLE LABORATORIES 398904 / 4 5 - / IM

Administered by: Public      Purchased by: Public
Symptoms: Urticaria

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: pt exp rxn in 1994 w/measles dose 2~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': SC96011

Write-up: father & stepmom states pt devel welts all over body (systemic rxn) by 4PM on the afternoon inj given;past records indicated a measles vax given in 1983 & father states had no rxn from inj;pt wasn''t taken to MD;


Changed on 2/14/2018

VAERS ID: 83750 Before After
VAERS Form:1
Age:16.0
Sex:Male
Location:South Carolina
Vaccinated:1996-02-28
Onset:1996-02-28
Submitted:1996-02-29
Entered:1996-03-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0619B / 2 - / SC
TD: TD ADSORBED (NO BRAND NAME) / LEDERLE LABORATORIES 398904 / 5 - / IM

Administered by: Public      Purchased by: Public
Symptoms: Urticaria

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: pt exp rxn in 1994 w/measles dose 2~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': SC96011

Write-up: father & stepmom states pt devel welts all over body (systemic rxn) by 4PM on the afternoon inj given;past records indicated a measles vax given in 1983 & father states had no rxn from inj;pt wasn''t taken to MD;


Changed on 6/14/2018

VAERS ID: 83750 Before After
VAERS Form:1
Age:16.0
Sex:Male
Location:South Carolina
Vaccinated:1996-02-28
Onset:1996-02-28
Submitted:1996-02-29
Entered:1996-03-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0619B / 2 - / SC
TD: TD ADSORBED (NO BRAND NAME) / LEDERLE LABORATORIES 398904 / 5 - / IM

Administered by: Public      Purchased by: Public
Symptoms: Urticaria

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: pt exp rxn in 1994 w/measles dose 2~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': SC96011

Write-up: father & stepmom states pt devel welts all over body (systemic rxn) by 4PM on the afternoon inj given;past records indicated a measles vax given in 1983 & father states had no rxn from inj;pt wasn''t taken to MD;


Changed on 8/14/2018

VAERS ID: 83750 Before After
VAERS Form:1
Age:16.0
Sex:Male
Location:South Carolina
Vaccinated:1996-02-28
Onset:1996-02-28
Submitted:1996-02-29
Entered:1996-03-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0619B / 2 - / SC
TD: TD ADSORBED (NO BRAND NAME) / LEDERLE LABORATORIES 398904 / 5 - / IM

Administered by: Public      Purchased by: Public
Symptoms: Urticaria

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: pt exp rxn in 1994 w/measles dose 2~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': SC96011

Write-up: father & stepmom states pt devel welts all over body (systemic rxn) by 4PM on the afternoon inj given;past records indicated a measles vax given in 1983 & father states had no rxn from inj;pt wasn''t taken to MD;


Changed on 9/14/2018

VAERS ID: 83750 Before After
VAERS Form:1
Age:16.0
Sex:Male
Location:South Carolina
Vaccinated:1996-02-28
Onset:1996-02-28
Submitted:1996-02-29
Entered:1996-03-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0619B / 2 - / SC
TD: TD ADSORBED (NO BRAND NAME) / LEDERLE LABORATORIES 398904 / 5 - / IM

Administered by: Public      Purchased by: Public
Symptoms: Urticaria

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: pt exp rxn in 1994 w/measles dose 2~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': SC96011

Write-up: father & stepmom states pt devel welts all over body (systemic rxn) by 4PM on the afternoon inj given;past records indicated a measles vax given in 1983 & father states had no rxn from inj;pt wasn''t taken to MD;


Changed on 10/14/2018

VAERS ID: 83750 Before After
VAERS Form:1
Age:16.0
Sex:Male
Location:South Carolina
Vaccinated:1996-02-28
Onset:1996-02-28
Submitted:1996-02-29
Entered:1996-03-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0619B / 2 - / SC
TD: TD ADSORBED (NO BRAND NAME) / LEDERLE LABORATORIES 398904 / 5 - / IM

Administered by: Public      Purchased by: Public
Symptoms: Urticaria

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: pt exp rxn in 1994 w/measles dose 2~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': SC96011

Write-up: father & stepmom states pt devel welts all over body (systemic rxn) by 4PM on the afternoon inj given;past records indicated a measles vax given in 1983 & father states had no rxn from inj;pt wasn''t taken to MD;

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=83750&WAYBACKHISTORY=ON


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