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This is VAERS ID 26005

Case Details

VAERS ID: 26005 (history)  
Form: Version 1.0  
Age: 3.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:1990-08-28
Onset:1990-08-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1470S / UNK - / SC

Administered by: Private       Purchased by: Unknown
Symptoms: Dyspnoea, Urticaria, Vasodilatation
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (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? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: ANTIHISTAMINE ORDER BY MD PER PHONE CALL
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: PT VACCINATED WITH MMR DEVELOPED WELTS & FLUSHED SKIN ON ARM, FACE & EARS APPROX 1 HR AFTER VAX. MOM CALLED MD HE ORDER ANTIHISTAMINE; PT ALSO HAD DIFFICULTY BREATHING.


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