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This is VAERS ID 25969

Case Details

VAERS ID: 25969 (history)  
Form: Version 1.0  
Age: 1.3  
Sex: Female  
Location: Pennsylvania  
Vaccinated:1990-09-12
Onset:1990-09-12
   Days after vaccination:0
Submitted: 1990-09-12
   Days after onset:0
Entered: 1990-09-17
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH PM240EC / UNK LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. M15685 / 1 RL / SC

Administered by: Private       Purchased by: Private
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), 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? No
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/HIBtiter experienced temp to 103+ 5-6 hrs after vaccine.


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