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This is VAERS ID 87228

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 87228
VAERS Form:
Age:17.7
Sex:Female
Location:Georgia
Vaccinated:1995-01-04
Onset:1995-01-13
Submitted:1996-06-20
Entered:1996-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II / MSD 0079A / - LA / -
TD: TD ADSORBED, ADULTS / CONNAUGHT LABS 4F61058 / - RA / -

Administered by: Public      Purchased by: Unknown
Symptoms: HYPERTONIA, ARTHRALGIA, ANEMIA HYPOCHROM, EDEMA PERIPH, ARTHROSIS

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: 9 days post vax inc WBC;3months post vax +RA factor;inc sed rate, inc EOS, dec hemoglobin
CDC 'Split Type': NONE

Write-up: 9 days post vax fever-lt shoulder pain-APAP -saw MD;blood work;pt started on ATB;given med for shoulder;pain rt shoulder, sore throat, congestion;also hot lt great toe;MD did x-rays showed soft tissue swelling-joint pain;+RA,n,effusion knee


Changed on 12/8/2009

VAERS ID: 87228 Before After
VAERS Form:
Age:17.7
Sex:Female
Location:Georgia
Vaccinated:1995-01-04
Onset:1995-01-13
Submitted:1996-06-20
Entered:1996-06-26 1996-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 0079A / - LA / -
TD: TD ADSORBED, ADULTS TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABS CONNAUGHT LABORATORIES 4F61058 / - RA / -

Administered by: Public      Purchased by: Unknown Private
Symptoms: Arthralgia, Arthropathy, Hypertonia, Hypochromic anaemia, Hypokinesia, Malaise, Oedema peripheral, Osteoarthritis, HYPERTONIA, ARTHRALGIA, ANEMIA HYPOCHROM, EDEMA PERIPH, ARTHROSIS

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: 9 days post vax inc WBC;3months post vax +RA factor;inc sed rate, inc EOS, dec hemoglobin
CDC 'Split Type': NONE (blank)

Write-up: 9 days post vax fever-lt shoulder pain-APAP -saw MD;blood work;pt started on ATB;given med for shoulder;pain rt shoulder, sore throat, congestion;also hot lt great toe;MD did x-rays showed soft tissue swelling-joint pain;+RA,n,effusion knee


Changed on 2/14/2017

VAERS ID: 87228 Before After
VAERS Form:
Age:17.7 17.0
Sex:Female
Location:Georgia
Vaccinated:1995-01-04
Onset:1995-01-13
Submitted:1996-06-20
Entered:1996-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0079A / - LA / -
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES 4F61058 / - RA / -

Administered by: Public      Purchased by: Private
Symptoms: Arthralgia, Arthropathy, Hypertonia, Hypochromic anaemia, Hypokinesia, Malaise, Oedema peripheral, Osteoarthritis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: 9 days post vax inc WBC;3months post vax +RA factor;inc sed rate, inc EOS, dec hemoglobin
CDC 'Split Type':

Write-up: 9 days post vax fever-lt shoulder pain-APAP -saw MD;blood work;pt started on ATB;given med for shoulder;pain rt shoulder, sore throat, congestion;also hot lt great toe;MD did x-rays showed soft tissue swelling-joint pain;+RA,n,effusion knee


Changed on 5/14/2017

VAERS ID: 87228 Before After
VAERS Form:
Age:17.0
Sex:Female
Location:Georgia
Vaccinated:1995-01-04
Onset:1995-01-13
Submitted:1996-06-20
Entered:1996-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0079A / - LA / -
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES 4F61058 / - RA / -

Administered by: Public      Purchased by: Private
Symptoms: Arthralgia, Arthropathy, Hypertonia, Hypochromic anaemia, Hypokinesia, Malaise, Oedema peripheral, Osteoarthritis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE NONE~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: 9 days post vax inc WBC;3months post vax +RA factor;inc sed rate, inc EOS, dec hemoglobin
CDC 'Split Type':

Write-up: 9 days post vax fever-lt shoulder pain-APAP -saw MD;blood work;pt started on ATB;given med for shoulder;pain rt shoulder, sore throat, congestion;also hot lt great toe;MD did x-rays showed soft tissue swelling-joint pain;+RA,n,effusion knee


Changed on 9/14/2017

VAERS ID: 87228 Before After
VAERS Form:(blank) 1
Age:17.0
Sex:Female
Location:Georgia
Vaccinated:1995-01-04
Onset:1995-01-13
Submitted:1996-06-20
Entered:1996-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0079A / - UNK LA / -
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES 4F61058 / - UNK RA / -

Administered by: Public      Purchased by: Private
Symptoms: Arthralgia, Arthropathy, Hypertonia, Hypochromic anaemia, Hypokinesia, Malaise, Oedema peripheral, Osteoarthritis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: 9 days post vax inc WBC;3months post vax +RA factor;inc sed rate, inc EOS, dec hemoglobin
CDC 'Split Type':

Write-up: 9 days post vax fever-lt shoulder pain-APAP -saw MD;blood work;pt started on ATB;given med for shoulder;pain rt shoulder, sore throat, congestion;also hot lt great toe;MD did x-rays showed soft tissue swelling-joint pain;+RA,n,effusion knee


Changed on 2/14/2018

VAERS ID: 87228 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:Georgia
Vaccinated:1995-01-04
Onset:1995-01-13
Submitted:1996-06-20
Entered:1996-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0079A / UNK LA / -
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES 4F61058 / UNK RA / -

Administered by: Public      Purchased by: Private
Symptoms: Arthralgia, Arthropathy, Hypertonia, Hypochromic anaemia, Hypokinesia, Malaise, Oedema peripheral, Osteoarthritis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: 9 days post vax inc WBC;3months post vax +RA factor;inc sed rate, inc EOS, dec hemoglobin
CDC 'Split Type':

Write-up: 9 days post vax fever-lt shoulder pain-APAP -saw MD;blood work;pt started on ATB;given med for shoulder;pain rt shoulder, sore throat, congestion;also hot lt great toe;MD did x-rays showed soft tissue swelling-joint pain;+RA,n,effusion knee


Changed on 6/14/2018

VAERS ID: 87228 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:Georgia
Vaccinated:1995-01-04
Onset:1995-01-13
Submitted:1996-06-20
Entered:1996-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0079A / UNK LA / -
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES 4F61058 / UNK RA / -

Administered by: Public      Purchased by: Private
Symptoms: Arthralgia, Arthropathy, Hypertonia, Hypochromic anaemia, Hypokinesia, Malaise, Oedema peripheral, Osteoarthritis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: 9 days post vax inc WBC;3months post vax +RA factor;inc sed rate, inc EOS, dec hemoglobin
CDC 'Split Type':

Write-up: 9 days post vax fever-lt shoulder pain-APAP -saw MD;blood work;pt started on ATB;given med for shoulder;pain rt shoulder, sore throat, congestion;also hot lt great toe;MD did x-rays showed soft tissue swelling-joint pain;+RA,n,effusion knee


Changed on 8/14/2018

VAERS ID: 87228 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:Georgia
Vaccinated:1995-01-04
Onset:1995-01-13
Submitted:1996-06-20
Entered:1996-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0079A / UNK LA / -
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES 4F61058 / UNK RA / -

Administered by: Public      Purchased by: Private
Symptoms: Arthralgia, Arthropathy, Hypertonia, Hypochromic anaemia, Hypokinesia, Malaise, Oedema peripheral, Osteoarthritis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: 9 days post vax inc WBC;3months post vax +RA factor;inc sed rate, inc EOS, dec hemoglobin
CDC 'Split Type':

Write-up: 9 days post vax fever-lt shoulder pain-APAP -saw MD;blood work;pt started on ATB;given med for shoulder;pain rt shoulder, sore throat, congestion;also hot lt great toe;MD did x-rays showed soft tissue swelling-joint pain;+RA,n,effusion knee


Changed on 9/14/2018

VAERS ID: 87228 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:Georgia
Vaccinated:1995-01-04
Onset:1995-01-13
Submitted:1996-06-20
Entered:1996-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0079A / UNK LA / -
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES 4F61058 / UNK RA / -

Administered by: Public      Purchased by: Private
Symptoms: Arthralgia, Arthropathy, Hypertonia, Hypochromic anaemia, Hypokinesia, Malaise, Oedema peripheral, Osteoarthritis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: 9 days post vax inc WBC;3months post vax +RA factor;inc sed rate, inc EOS, dec hemoglobin
CDC 'Split Type':

Write-up: 9 days post vax fever-lt shoulder pain-APAP -saw MD;blood work;pt started on ATB;given med for shoulder;pain rt shoulder, sore throat, congestion;also hot lt great toe;MD did x-rays showed soft tissue swelling-joint pain;+RA,n,effusion knee


Changed on 10/14/2018

VAERS ID: 87228 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:Georgia
Vaccinated:1995-01-04
Onset:1995-01-13
Submitted:1996-06-20
Entered:1996-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0079A / UNK LA / -
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES 4F61058 / UNK RA / -

Administered by: Public      Purchased by: Private
Symptoms: Arthralgia, Arthropathy, Hypertonia, Hypochromic anaemia, Hypokinesia, Malaise, Oedema peripheral, Osteoarthritis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: 9 days post vax inc WBC;3months post vax +RA factor;inc sed rate, inc EOS, dec hemoglobin
CDC 'Split Type':

Write-up: 9 days post vax fever-lt shoulder pain-APAP -saw MD;blood work;pt started on ATB;given med for shoulder;pain rt shoulder, sore throat, congestion;also hot lt great toe;MD did x-rays showed soft tissue swelling-joint pain;+RA,n,effusion knee

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