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This is VAERS ID 25981

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 25981
VAERS Form:
Age:18.4
Sex:Male
Location:New Jersey
Vaccinated:1990-09-05
Onset:1990-09-06
Submitted:1990-09-12
Entered:1990-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II / MSD 0692S / 1 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: INJECT SITE REACT

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 swelling & tenderness of side.


Changed on 12/8/2009

VAERS ID: 25981 Before After
VAERS Form:
Age:18.4
Sex:Male
Location:New Jersey
Vaccinated:1990-09-05
Onset:1990-09-06
Submitted:1990-09-12
Entered:1990-09-25 1990-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 0692S / 1 LA / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Injection site reaction, INJECT SITE REACT

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 swelling & tenderness of side.


Changed on 2/14/2017

VAERS ID: 25981 Before After
VAERS Form:
Age:18.4 18.0
Sex:Male
Location:New Jersey
Vaccinated:1990-09-05
Onset:1990-09-06
Submitted:1990-09-12
Entered:1990-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0692S / 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Injection site reaction

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 swelling & tenderness of side.


Changed on 5/14/2017

VAERS ID: 25981 Before After
VAERS Form:
Age:18.0
Sex:Male
Location:New Jersey
Vaccinated:1990-09-05
Onset:1990-09-06
Submitted:1990-09-12
Entered:1990-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0692S / 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Injection site reaction

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 swelling & tenderness of side.


Changed on 9/14/2017

VAERS ID: 25981 Before After
VAERS Form:(blank) 1
Age:18.0
Sex:Male
Location:New Jersey
Vaccinated:1990-09-05
Onset:1990-09-06
Submitted:1990-09-12
Entered:1990-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0692S / 1 2 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Injection site reaction

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 swelling & tenderness of side.


Changed on 2/14/2018

VAERS ID: 25981 Before After
VAERS Form:1
Age:18.0
Sex:Male
Location:New Jersey
Vaccinated:1990-09-05
Onset:1990-09-06
Submitted:1990-09-12
Entered:1990-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0692S / 2 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Injection site reaction

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 swelling & tenderness of side.


Changed on 6/14/2018

VAERS ID: 25981 Before After
VAERS Form:1
Age:18.0
Sex:Male
Location:New Jersey
Vaccinated:1990-09-05
Onset:1990-09-06
Submitted:1990-09-12
Entered:1990-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0692S / 2 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Injection site reaction

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 swelling & tenderness of side.


Changed on 8/14/2018

VAERS ID: 25981 Before After
VAERS Form:1
Age:18.0
Sex:Male
Location:New Jersey
Vaccinated:1990-09-05
Onset:1990-09-06
Submitted:1990-09-12
Entered:1990-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0692S / 2 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Injection site reaction

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 swelling & tenderness of side.


Changed on 9/14/2018

VAERS ID: 25981 Before After
VAERS Form:1
Age:18.0
Sex:Male
Location:New Jersey
Vaccinated:1990-09-05
Onset:1990-09-06
Submitted:1990-09-12
Entered:1990-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0692S / 2 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Injection site reaction

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 swelling & tenderness of side.


Changed on 10/14/2018

VAERS ID: 25981 Before After
VAERS Form:1
Age:18.0
Sex:Male
Location:New Jersey
Vaccinated:1990-09-05
Onset:1990-09-06
Submitted:1990-09-12
Entered:1990-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0692S / 2 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Injection site reaction

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 swelling & tenderness of side.

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