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This is VAERS ID 25876

Case Details

VAERS ID: 25876 (history)  
Form: Version 1.0  
Age: 1.3  
Sex: Male  
Location: Kansas  
Vaccinated:1990-08-29
Onset:1990-09-05
   Days after vaccination:7
Submitted: 1990-09-06
   Days after onset:1
Entered: 1990-09-11
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 14955 / UNK - / L

Administered by: Private       Purchased by: Private
Symptoms: Pyrexia, Rash maculo-papular
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
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 vaccinated with MMR developed rash, blotchy on face trunk, temp 101 extremities - macular


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