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From the 1/14/2022 release of VAERS data:

This is VAERS ID 1800753

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Case Details

VAERS ID: 1800753 (history)  
Form: Version 2.0  
Age: 4.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-10-08
Onset:2021-10-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR - / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Headache, Hypophagia, Influenza virus test negative, Injection site rash, Malaise, Pyrexia, Rash pruritic, Rhinorrhoea, SARS-CoV-2 test negative, Streptococcus test negative
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None.
Current Illness: None
Preexisting Conditions: None
Allergies: Amoxicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: The patient is otherwise healthy. Five days ago the patient received his MMR vaccine and DTaP. Four days ago the patient''s fever began. Three days ago the patient''s fever became higher to 100 to an a patient felt ill. He had a rash that began around the injection site. The rash was itchy. He also had a mild runny nose that was clear and requiring tissue. But he did not have a cough or a sore throat. Yesterday the patient was seen in his pediatricians office. He was negative for all of the following: COVID-19, influenza, and strep throat. His hematocrit, platelets and granulocytes were mildly high, Pediatrician was unsure of the diagnosis or the ideology. Last night the fever was 102 and patient complained of headache. Today, the patient is doing better and that he feels better. He is eating and drinking but not as much as he usually does. His runny nose has resolved. His fever tonight is lower, in the upper 99 range. However his rash persists as in the photographs and is itchy. Patient has had no diarrhea to suggest Coxsackie virus.


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