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This is VAERS ID 662458

History of Changes from the VAERS Wayback Machine

First Appeared on 1/14/2017

VAERS ID: 662458
VAERS Form:
Age:3.0
Gender:Male
Location:Vermont
Vaccinated:2016-10-12
Onset:2016-10-28
Submitted:2016-10-29
Entered:2016-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 0 RA / IM

Administered by: Unknown      Purchased by: Private
Symptoms: Erythema multiforme, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: Rash, fever, febrile seizure~DTaP + IPV + Hib (Unknown)~2~0.33~Patient
Other Medications:
Current Illness: No
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Fever, Erythema multiforme.


Changed on 9/14/2017

VAERS ID: 662458 Before After
VAERS Form:(blank) 1
Age:3.0
Gender:Male
Location:Vermont
Vaccinated:2016-10-12
Onset:2016-10-28
Submitted:2016-10-29
Entered:2016-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 0 1 RA / IM

Administered by: Unknown      Purchased by: Private
Symptoms: Erythema multiforme, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: Rash, fever, febrile seizure~DTaP + IPV + Hib (Unknown)~2~0.33~Patient
Other Medications:
Current Illness: No
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Fever, Erythema multiforme.


Changed on 2/14/2018

VAERS ID: 662458 Before After
VAERS Form:1
Age:3.0
Gender:Male
Location:Vermont
Vaccinated:2016-10-12
Onset:2016-10-28
Submitted:2016-10-29
Entered:2016-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 1 RA / IM

Administered by: Unknown      Purchased by: Private
Symptoms: Erythema multiforme, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: Rash, fever, febrile seizure~DTaP + IPV + Hib (Unknown)~2~0.33~Patient
Other Medications:
Current Illness: No
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Fever, Erythema multiforme.


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http://medalerts.org/vaersdb/findfield.php?IDNUMBER=662458&WAYBACKHISTORY=ON


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