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This is VAERS ID 25236

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 25236
VAERS Form:
Age:15.0
Sex:Female
Location:Wisconsin
Vaccinated:1990-06-04
Onset:1990-06-04
Submitted:0000-00-00
Entered:1990-07-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II / MSD 08905 / - - / SC
TD: UNK.TD ADSORBED, ADULTS / UNCLASSIFIED - / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: EDEMA FACE

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: given Benadryl /p vaccine
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 1 hr /p receiving Td & MMR returned to DHC /w swollen itching eyes, no respiratory distress, treated /w Benadryl 50 mg


Changed on 12/8/2009

VAERS ID: 25236 Before After
VAERS Form:
Age:15.0
Sex:Female
Location:Wisconsin
Vaccinated:1990-06-04
Onset:1990-06-04
Submitted:0000-00-00
Entered:1990-07-26 1990-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 08905 / - - / SC
TD: UNK.TD ADSORBED, ADULTS TD ADSORBED (NO BRAND NAME) / UNCLASSIFIED UNKNOWN MANUFACTURER - / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Face oedema, EDEMA FACE

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: given Benadryl /p vaccine
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 1 hr /p receiving Td & MMR returned to DHC /w swollen itching eyes, no respiratory distress, treated /w Benadryl 50 mg


Changed on 5/14/2017

VAERS ID: 25236 Before After
VAERS Form:
Age:15.0
Sex:Female
Location:Wisconsin
Vaccinated:1990-06-04
Onset:1990-06-04
Submitted:0000-00-00
Entered:1990-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 08905 / - - / SC
TD: TD ADSORBED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Face oedema

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: ~ ()~~~In patient
Other Medications: given Benadryl /p vaccine
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 1 hr /p receiving Td & MMR returned to DHC /w swollen itching eyes, no respiratory distress, treated /w Benadryl 50 mg


Changed on 9/14/2017

VAERS ID: 25236 Before After
VAERS Form:(blank) 1
Age:15.0
Sex:Female
Location:Wisconsin
Vaccinated:1990-06-04
Onset:1990-06-04
Submitted:0000-00-00
Entered:1990-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 08905 / - UNK - / SC
TD: TD ADSORBED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Face oedema

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: ~ ()~~~In patient
Other Medications: given Benadryl /p vaccine
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 1 hr /p receiving Td & MMR returned to DHC /w swollen itching eyes, no respiratory distress, treated /w Benadryl 50 mg


Changed on 2/14/2018

VAERS ID: 25236 Before After
VAERS Form:1
Age:15.0
Sex:Female
Location:Wisconsin
Vaccinated:1990-06-04
Onset:1990-06-04
Submitted:0000-00-00
Entered:1990-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 08905 / UNK - / SC
TD: TD ADSORBED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Face oedema

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: ~ ()~~~In patient
Other Medications: given Benadryl /p vaccine
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 1 hr /p receiving Td & MMR returned to DHC /w swollen itching eyes, no respiratory distress, treated /w Benadryl 50 mg


Changed on 6/14/2018

VAERS ID: 25236 Before After
VAERS Form:1
Age:15.0
Sex:Female
Location:Wisconsin
Vaccinated:1990-06-04
Onset:1990-06-04
Submitted:0000-00-00
Entered:1990-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 08905 / UNK - / SC
TD: TD ADSORBED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Face oedema

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: ~ ()~~~In patient
Other Medications: given Benadryl /p vaccine
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 1 hr /p receiving Td & MMR returned to DHC /w swollen itching eyes, no respiratory distress, treated /w Benadryl 50 mg


Changed on 8/14/2018

VAERS ID: 25236 Before After
VAERS Form:1
Age:15.0
Sex:Female
Location:Wisconsin
Vaccinated:1990-06-04
Onset:1990-06-04
Submitted:0000-00-00
Entered:1990-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 08905 / UNK - / SC
TD: TD ADSORBED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Face oedema

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: ~ ()~~~In patient
Other Medications: given Benadryl /p vaccine
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 1 hr /p receiving Td & MMR returned to DHC /w swollen itching eyes, no respiratory distress, treated /w Benadryl 50 mg


Changed on 9/14/2018

VAERS ID: 25236 Before After
VAERS Form:1
Age:15.0
Sex:Female
Location:Wisconsin
Vaccinated:1990-06-04
Onset:1990-06-04
Submitted:0000-00-00
Entered:1990-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 08905 / UNK - / SC
TD: TD ADSORBED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Face oedema

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: ~ ()~~~In patient
Other Medications: given Benadryl /p vaccine
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 1 hr /p receiving Td & MMR returned to DHC /w swollen itching eyes, no respiratory distress, treated /w Benadryl 50 mg


Changed on 10/14/2018

VAERS ID: 25236 Before After
VAERS Form:1
Age:15.0
Sex:Female
Location:Wisconsin
Vaccinated:1990-06-04
Onset:1990-06-04
Submitted:0000-00-00
Entered:1990-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 08905 / UNK - / SC
TD: TD ADSORBED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Face oedema

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: ~ ()~~~In patient
Other Medications: given Benadryl /p vaccine
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 1 hr /p receiving Td & MMR returned to DHC /w swollen itching eyes, no respiratory distress, treated /w Benadryl 50 mg

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