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This is VAERS ID 25633

Case Details

VAERS ID: 25633 (history)  
Form: Version 1.0  
Age: 6.0  
Sex: Male  
Location: Mississippi  
Vaccinated:1990-07-18
Onset:1990-07-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 1990-08-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 02135 / UNK - / -

Administered by: Private       Purchased by: Unknown
Symptoms: Rash, Urticaria, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt received MMR on 18Aug90 & 24 hrs later developed facial redness /w urticarial rash over remainder of body. Rash cleared /p 48 hrs.


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