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This is VAERS ID 25819

Case Details

VAERS ID: 25819 (history)  
Form: Version 1.0  
Age: 17.0  
Sex: Female  
Location: New York  
Vaccinated:1990-06-15
Onset:1990-06-26
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 1990-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1227S / UNK - / -

Administered by: Private       Purchased by: Unknown
Symptoms: Arthritis, Back pain, Malaise, Pharyngitis, Pyrexia
SMQs:, Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Oropharyngeal infections (narrow), Arthritis (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: Juvenile rheumatoid arthritis
Allergies:
Diagnostic Lab Data:
CDC Split Type: WAES90080353

Write-up: Pt with juvenile rheumatoid arthritis vaccinated with MMR developed body aches, fever, sore throat, back pain, and arthritic symptoms which were thought to be a recurrence of juvenile rhematoid arthritis.


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