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This is VAERS ID 25876

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 25876
VAERS Form:
Age:1.3
Sex:Male
Location:Kansas
Vaccinated:1990-08-29
Onset:1990-09-05
Submitted:1990-09-06
Entered:1990-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II / MSD 14955 / - L / -

Administered by: Private      Purchased by: Unknown
Symptoms: FEVER, RASH MAC PAP

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
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 developed rash, blotchy on face trunk, temp 101 extremities - macular


Changed on 12/8/2009

VAERS ID: 25876 Before After
VAERS Form:
Age:1.3
Sex:Male
Location:Kansas
Vaccinated:1990-08-29
Onset:1990-09-05
Submitted:1990-09-06
Entered:1990-09-13 1990-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 14955 / - L / -

Administered by: Private      Purchased by: Unknown Private
Symptoms: Pyrexia, Rash maculo-papular, FEVER, RASH MAC PAP

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
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 developed rash, blotchy on face trunk, temp 101 extremities - macular


Changed on 5/14/2017

VAERS ID: 25876 Before After
VAERS Form:
Age:1.3
Sex:Male
Location:Kansas
Vaccinated:1990-08-29
Onset:1990-09-05
Submitted:1990-09-06
Entered:1990-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 14955 / - L - / - L

Administered by: Private      Purchased by: Private
Symptoms: Pyrexia, Rash maculo-papular

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
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 developed rash, blotchy on face trunk, temp 101 extremities - macular


Changed on 9/14/2017

VAERS ID: 25876 Before After
VAERS Form:(blank) 1
Age:1.3
Sex:Male
Location:Kansas
Vaccinated:1990-08-29
Onset:1990-09-05
Submitted:1990-09-06
Entered:1990-09-11
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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
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 developed rash, blotchy on face trunk, temp 101 extremities - macular


Changed on 2/14/2018

VAERS ID: 25876 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:Kansas
Vaccinated:1990-08-29
Onset:1990-09-05
Submitted:1990-09-06
Entered:1990-09-11
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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
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 developed rash, blotchy on face trunk, temp 101 extremities - macular


Changed on 6/14/2018

VAERS ID: 25876 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:Kansas
Vaccinated:1990-08-29
Onset:1990-09-05
Submitted:1990-09-06
Entered:1990-09-11
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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
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 developed rash, blotchy on face trunk, temp 101 extremities - macular


Changed on 8/14/2018

VAERS ID: 25876 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:Kansas
Vaccinated:1990-08-29
Onset:1990-09-05
Submitted:1990-09-06
Entered:1990-09-11
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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
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 developed rash, blotchy on face trunk, temp 101 extremities - macular


Changed on 9/14/2018

VAERS ID: 25876 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:Kansas
Vaccinated:1990-08-29
Onset:1990-09-05
Submitted:1990-09-06
Entered:1990-09-11
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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
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 developed rash, blotchy on face trunk, temp 101 extremities - macular


Changed on 10/14/2018

VAERS ID: 25876 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:Kansas
Vaccinated:1990-08-29
Onset:1990-09-05
Submitted:1990-09-06
Entered:1990-09-11
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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
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 developed rash, blotchy on face trunk, temp 101 extremities - macular

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=25876&WAYBACKHISTORY=ON


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