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This is VAERS ID 25968

Case Details

VAERS ID: 25968 (history)  
Form: Version 1.0  
Age: 11.0  
Sex: Male  
Location: Illinois  
Vaccinated:1990-08-17
Onset:1990-08-18
   Days after vaccination:1
Submitted: 1990-09-13
   Days after onset:26
Entered: 1990-09-17
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 14735 / UNK - / -

Administered by: Private       Purchased by: Private
Symptoms: Diarrhoea, Hepatitis, Nausea, Pharyngitis, Vomiting
SMQs:, Hepatitis, non-infectious (narrow), Acute pancreatitis (broad), Agranulocytosis (broad), Pseudomembranous colitis (broad), Oropharyngeal infections (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (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? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: Mild cold symptom
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Following MMR had URI symptom including N/V/D. Evaluation on 24AUG90 showed abd soft with mild generalized tenderness. GI liver enlargement noted. 1cm below ribs.


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