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This is VAERS ID 1813003

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/29/2021

VAERS ID: 1813003
VAERS Form:2
Age:
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:2021-10-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Injury, Autism spectrum disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': US0095075132110USA004021

Write-up: autism; was injured physically; This spontaneous report was received from a consumer (patient''s father) via Pfizer and refers to a male patient who was 18 years old at the time of the report. The patient''s historical condition, concomitant medications, allergies or drug reactions were not reported. In approximately 2004 (reported as "16 or 17" years ago), the patient was vaccinated with measles, mumps, and rubella (wistar ra 27-3) virus vaccine, live (manufacturer unknown) for prophylaxis and/or diphtheria vaccine toxoid, pertussis vaccine acellular, tetanus vaccine toxoid (DTAP) (dose, route of administration, lot # and expiration date was not reported for both vaccines). On an unknown date, in approximately 2004 (reported as "16 or 17 years ago" and "within 36 hours"), the patient was injured physically. On an unknown date, the patient experienced autism (also reported as current condition, however the given dates, type of event an context of the report indicated that it could be an event). The outcome of autism spectrum disorder was considered as not recovered/not resolved. The outcome of unspecified physical injury was unknown. It was additionally reported, that "health-wise on autism portion, his son is pretty healthy". The causality assessment was unknown. Upon internal review, the event of autism was considered to be medically significant.

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