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This is VAERS ID 25863

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 25863
VAERS Form:
Age:6.2
Sex:Female
Location:New York
Vaccinated:1990-08-28
Onset:1990-09-02
Submitted:1990-09-04
Entered:1990-09-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II / MSD 15245 / 1 - / IM
OPV: UNK. POLIOVIRUS LIVE ORAL TRIVALENT / UNCLASSIFIED - / 4 - / PO

Administered by: Private      Purchased by: Unknown
Symptoms: RASH, 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with MMR/OPV developed erythematous papular rash on abdomen, face swollen, rash occured 5 days after vaccine, tx benadryl, icepacks.


Changed on 12/8/2009

VAERS ID: 25863 Before After
VAERS Form:
Age:6.2
Sex:Female
Location:New York
Vaccinated:1990-08-28
Onset:1990-09-02
Submitted:1990-09-04
Entered:1990-09-12 1990-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 15245 / 1 - / IM
OPV: UNK. POLIOVIRUS LIVE ORAL TRIVALENT POLIO VIRUS, ORAL (NO BRAND NAME) / UNCLASSIFIED UNKNOWN MANUFACTURER - / 4 - / PO

Administered by: Private      Purchased by: Unknown Private
Symptoms: Face oedema, Rash, RASH, 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with MMR/OPV developed erythematous papular rash on abdomen, face swollen, rash occured 5 days after vaccine, tx benadryl, icepacks.


Changed on 2/14/2017

VAERS ID: 25863 Before After
VAERS Form:
Age:6.2 6.0
Sex:Female
Location:New York
Vaccinated:1990-08-28
Onset:1990-09-02
Submitted:1990-09-04
Entered:1990-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 15245 / 1 - / IM
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 4 - / PO

Administered by: Private      Purchased by: Private
Symptoms: Face oedema, Rash

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':

Write-up: Pt vaccinated with MMR/OPV developed erythematous papular rash on abdomen, face swollen, rash occured 5 days after vaccine, tx benadryl, icepacks.


Changed on 5/14/2017

VAERS ID: 25863 Before After
VAERS Form:
Age:6.0
Sex:Female
Location:New York
Vaccinated:1990-08-28
Onset:1990-09-02
Submitted:1990-09-04
Entered:1990-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 15245 / 1 - / IM
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 4 - / PO

Administered by: Private      Purchased by: Private
Symptoms: Face oedema, Rash

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with MMR/OPV developed erythematous papular rash on abdomen, face swollen, rash occured 5 days after vaccine, tx benadryl, icepacks.


Changed on 9/14/2017

VAERS ID: 25863 Before After
VAERS Form:(blank) 1
Age:6.0
Sex:Female
Location:New York
Vaccinated:1990-08-28
Onset:1990-09-02
Submitted:1990-09-04
Entered:1990-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 15245 / 1 2 - / IM
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 4 5 - MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Face oedema, Rash

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with MMR/OPV developed erythematous papular rash on abdomen, face swollen, rash occured 5 days after vaccine, tx benadryl, icepacks.


Changed on 2/14/2018

VAERS ID: 25863 Before After
VAERS Form:1
Age:6.0
Sex:Female
Location:New York
Vaccinated:1990-08-28
Onset:1990-09-02
Submitted:1990-09-04
Entered:1990-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 15245 / 2 - / IM
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 5 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Face oedema, Rash

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with MMR/OPV developed erythematous papular rash on abdomen, face swollen, rash occured 5 days after vaccine, tx benadryl, icepacks.


Changed on 6/14/2018

VAERS ID: 25863 Before After
VAERS Form:1
Age:6.0
Sex:Female
Location:New York
Vaccinated:1990-08-28
Onset:1990-09-02
Submitted:1990-09-04
Entered:1990-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 15245 / 2 - / IM
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 5 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Face oedema, Rash

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with MMR/OPV developed erythematous papular rash on abdomen, face swollen, rash occured 5 days after vaccine, tx benadryl, icepacks.


Changed on 8/14/2018

VAERS ID: 25863 Before After
VAERS Form:1
Age:6.0
Sex:Female
Location:New York
Vaccinated:1990-08-28
Onset:1990-09-02
Submitted:1990-09-04
Entered:1990-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 15245 / 2 - / IM
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 5 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Face oedema, Rash

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with MMR/OPV developed erythematous papular rash on abdomen, face swollen, rash occured 5 days after vaccine, tx benadryl, icepacks.


Changed on 9/14/2018

VAERS ID: 25863 Before After
VAERS Form:1
Age:6.0
Sex:Female
Location:New York
Vaccinated:1990-08-28
Onset:1990-09-02
Submitted:1990-09-04
Entered:1990-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 15245 / 2 - / IM
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 5 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Face oedema, Rash

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with MMR/OPV developed erythematous papular rash on abdomen, face swollen, rash occured 5 days after vaccine, tx benadryl, icepacks.


Changed on 10/14/2018

VAERS ID: 25863 Before After
VAERS Form:1
Age:6.0
Sex:Female
Location:New York
Vaccinated:1990-08-28
Onset:1990-09-02
Submitted:1990-09-04
Entered:1990-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 15245 / 2 - / IM
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 5 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Face oedema, Rash

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with MMR/OPV developed erythematous papular rash on abdomen, face swollen, rash occured 5 days after vaccine, tx benadryl, icepacks.

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