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This is VAERS ID 25635

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 25635
VAERS Form:
Age:15.0
Sex:Female
Location:New York
Vaccinated:1990-06-18
Onset:1990-07-01
Submitted:0000-00-00
Entered:1990-08-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II / MSD 0435S / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: ANA, FEVER, ASTHENIA, ESR INC, ANEMIA

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: WBC-4,800 6/18/90; Hematocrit-41 6/18/90; Hematocrit-40 7/90; WBC-21,000 7/90, Granulocytes-80 7/90 Lymphocytes-20 7/90; ESR-83 7/7/90; WBC-20,000 7/7/90; hematocrit-30; Monospot-negative 7/90
CDC 'Split Type':

Write-up: Pt vax w/MMRII on 4JUL90 dev T of 104 & sore throat, she fainted & dev a macular rash on both thighs; She exp weakness & pain.F/U 12MAR91: SXS INCLUDED T 104, SORE THROAT, MAC RASH, FAINTED, WBC 21,000 W/ LEFT SHIFT, ANA +, ESR 83, HCT 30.


Changed on 12/8/2009

VAERS ID: 25635 Before After
VAERS Form:
Age:15.0
Sex:Female
Location:New York
Vaccinated:1990-06-18
Onset:1990-07-01
Submitted:0000-00-00
Entered:1990-08-08 1990-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 0435S / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: ANA, Anaemia, Antinuclear antibody, Asthenia, Leukocytosis, Malaise, Pharyngitis, Pyrexia, Rash maculo-papular, Syncope, Red blood cell sedimentation rate increased, White blood cell disorder, FEVER, ASTHENIA, ESR INC, ANEMIA

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: WBC-4,800 6/18/90; Hematocrit-41 6/18/90; Hematocrit-40 7/90; WBC-21,000 7/90, Granulocytes-80 7/90 Lymphocytes-20 7/90; ESR-83 7/7/90; WBC-20,000 7/7/90; hematocrit-30; Monospot-negative 7/90
CDC 'Split Type': (blank) WAES90070297

Write-up: Pt vax w/MMRII on 4JUL90 dev T of 104 & sore throat, she fainted & dev a macular rash on both thighs; She exp weakness & pain.F/U 12MAR91: SXS INCLUDED T 104, SORE THROAT, MAC RASH, FAINTED, WBC 21,000 W/ LEFT SHIFT, ANA +, ESR 83, HCT 30.


Changed on 5/14/2017

VAERS ID: 25635 Before After
VAERS Form:
Age:15.0
Sex:Female
Location:New York
Vaccinated:1990-06-18
Onset:1990-07-01
Submitted:0000-00-00
Entered:1990-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0435S / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Anaemia, Antinuclear antibody, Asthenia, Leukocytosis, Malaise, Pharyngitis, Pyrexia, Rash maculo-papular, Syncope, Red blood cell sedimentation rate increased, White blood cell 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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: WBC-4,800 6/18/90; Hematocrit-41 6/18/90; Hematocrit-40 7/90; WBC-21,000 7/90, Granulocytes-80 7/90 Lymphocytes-20 7/90; ESR-83 7/7/90; WBC-20,000 7/7/90; hematocrit-30; Monospot-negative 7/90
CDC 'Split Type': WAES90070297

Write-up: Pt vax w/MMRII on 4JUL90 dev T of 104 & sore throat, she fainted & dev a macular rash on both thighs; She exp weakness & pain.F/U 12MAR91: SXS INCLUDED T 104, SORE THROAT, MAC RASH, FAINTED, WBC 21,000 W/ LEFT SHIFT, ANA +, ESR 83, HCT 30.


Changed on 9/14/2017

VAERS ID: 25635 Before After
VAERS Form:(blank) 1
Age:15.0
Sex:Female
Location:New York
Vaccinated:1990-06-18
Onset:1990-07-01
Submitted:0000-00-00
Entered:1990-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0435S / - UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Anaemia, Antinuclear antibody, Asthenia, Leukocytosis, Malaise, Pharyngitis, Pyrexia, Rash maculo-papular, Syncope, Red blood cell sedimentation rate increased, White blood cell 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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: WBC-4,800 6/18/90; Hematocrit-41 6/18/90; Hematocrit-40 7/90; WBC-21,000 7/90, Granulocytes-80 7/90 Lymphocytes-20 7/90; ESR-83 7/7/90; WBC-20,000 7/7/90; hematocrit-30; Monospot-negative 7/90
CDC 'Split Type': WAES90070297

Write-up: Pt vax w/MMRII on 4JUL90 dev T of 104 & sore throat, she fainted & dev a macular rash on both thighs; She exp weakness & pain.F/U 12MAR91: SXS INCLUDED T 104, SORE THROAT, MAC RASH, FAINTED, WBC 21,000 W/ LEFT SHIFT, ANA +, ESR 83, HCT 30.


Changed on 2/14/2018

VAERS ID: 25635 Before After
VAERS Form:1
Age:15.0
Sex:Female
Location:New York
Vaccinated:1990-06-18
Onset:1990-07-01
Submitted:0000-00-00
Entered:1990-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0435S / UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Anaemia, Antinuclear antibody, Asthenia, Leukocytosis, Malaise, Pharyngitis, Pyrexia, Rash maculo-papular, Syncope, Red blood cell sedimentation rate increased, White blood cell 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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: WBC-4,800 6/18/90; Hematocrit-41 6/18/90; Hematocrit-40 7/90; WBC-21,000 7/90, Granulocytes-80 7/90 Lymphocytes-20 7/90; ESR-83 7/7/90; WBC-20,000 7/7/90; hematocrit-30; Monospot-negative 7/90
CDC 'Split Type': WAES90070297

Write-up: Pt vax w/MMRII on 4JUL90 dev T of 104 & sore throat, she fainted & dev a macular rash on both thighs; She exp weakness & pain.F/U 12MAR91: SXS INCLUDED T 104, SORE THROAT, MAC RASH, FAINTED, WBC 21,000 W/ LEFT SHIFT, ANA +, ESR 83, HCT 30.


Changed on 6/14/2018

VAERS ID: 25635 Before After
VAERS Form:1
Age:15.0
Sex:Female
Location:New York
Vaccinated:1990-06-18
Onset:1990-07-01
Submitted:0000-00-00
Entered:1990-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0435S / UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Anaemia, Antinuclear antibody, Asthenia, Leukocytosis, Malaise, Pharyngitis, Pyrexia, Rash maculo-papular, Syncope, Red blood cell sedimentation rate increased, White blood cell 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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: WBC-4,800 6/18/90; Hematocrit-41 6/18/90; Hematocrit-40 7/90; WBC-21,000 7/90, Granulocytes-80 7/90 Lymphocytes-20 7/90; ESR-83 7/7/90; WBC-20,000 7/7/90; hematocrit-30; Monospot-negative 7/90
CDC 'Split Type': WAES90070297

Write-up: Pt vax w/MMRII on 4JUL90 dev T of 104 & sore throat, she fainted & dev a macular rash on both thighs; She exp weakness & pain.F/U 12MAR91: SXS INCLUDED T 104, SORE THROAT, MAC RASH, FAINTED, WBC 21,000 W/ LEFT SHIFT, ANA +, ESR 83, HCT 30.


Changed on 8/14/2018

VAERS ID: 25635 Before After
VAERS Form:1
Age:15.0
Sex:Female
Location:New York
Vaccinated:1990-06-18
Onset:1990-07-01
Submitted:0000-00-00
Entered:1990-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0435S / UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Anaemia, Antinuclear antibody, Asthenia, Leukocytosis, Malaise, Pharyngitis, Pyrexia, Rash maculo-papular, Syncope, Red blood cell sedimentation rate increased, White blood cell 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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: WBC-4,800 6/18/90; Hematocrit-41 6/18/90; Hematocrit-40 7/90; WBC-21,000 7/90, Granulocytes-80 7/90 Lymphocytes-20 7/90; ESR-83 7/7/90; WBC-20,000 7/7/90; hematocrit-30; Monospot-negative 7/90
CDC 'Split Type': WAES90070297

Write-up: Pt vax w/MMRII on 4JUL90 dev T of 104 & sore throat, she fainted & dev a macular rash on both thighs; She exp weakness & pain.F/U 12MAR91: SXS INCLUDED T 104, SORE THROAT, MAC RASH, FAINTED, WBC 21,000 W/ LEFT SHIFT, ANA +, ESR 83, HCT 30.


Changed on 9/14/2018

VAERS ID: 25635 Before After
VAERS Form:1
Age:15.0
Sex:Female
Location:New York
Vaccinated:1990-06-18
Onset:1990-07-01
Submitted:0000-00-00
Entered:1990-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0435S / UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Anaemia, Antinuclear antibody, Asthenia, Leukocytosis, Malaise, Pharyngitis, Pyrexia, Rash maculo-papular, Syncope, Red blood cell sedimentation rate increased, White blood cell 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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: WBC-4,800 6/18/90; Hematocrit-41 6/18/90; Hematocrit-40 7/90; WBC-21,000 7/90, Granulocytes-80 7/90 Lymphocytes-20 7/90; ESR-83 7/7/90; WBC-20,000 7/7/90; hematocrit-30; Monospot-negative 7/90
CDC 'Split Type': WAES90070297

Write-up: Pt vax w/MMRII on 4JUL90 dev T of 104 & sore throat, she fainted & dev a macular rash on both thighs; She exp weakness & pain.F/U 12MAR91: SXS INCLUDED T 104, SORE THROAT, MAC RASH, FAINTED, WBC 21,000 W/ LEFT SHIFT, ANA +, ESR 83, HCT 30.


Changed on 10/14/2018

VAERS ID: 25635 Before After
VAERS Form:1
Age:15.0
Sex:Female
Location:New York
Vaccinated:1990-06-18
Onset:1990-07-01
Submitted:0000-00-00
Entered:1990-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0435S / UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Anaemia, Antinuclear antibody, Asthenia, Leukocytosis, Malaise, Pharyngitis, Pyrexia, Rash maculo-papular, Syncope, Red blood cell sedimentation rate increased, White blood cell 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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: WBC-4,800 6/18/90; Hematocrit-41 6/18/90; Hematocrit-40 7/90; WBC-21,000 7/90, Granulocytes-80 7/90 Lymphocytes-20 7/90; ESR-83 7/7/90; WBC-20,000 7/7/90; hematocrit-30; Monospot-negative 7/90
CDC 'Split Type': WAES90070297

Write-up: Pt vax w/MMRII on 4JUL90 dev T of 104 & sore throat, she fainted & dev a macular rash on both thighs; She exp weakness & pain.F/U 12MAR91: SXS INCLUDED T 104, SORE THROAT, MAC RASH, FAINTED, WBC 21,000 W/ LEFT SHIFT, ANA +, ESR 83, HCT 30.

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