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This is VAERS ID 26931

Case Details

VAERS ID: 26931 (history)  
Form: Version 1.0  
Age: 6.0  
Sex: Female  
Location: Missouri  
Vaccinated:1990-09-28
Onset:1990-09-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 1990-12-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 11495 / UNK - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Arthralgia, Ecchymosis, Rash
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hypersensitivity (narrow), Arthritis (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: Amoxil for poss sinus infection & local skin infection.
Current Illness:
Preexisting Conditions: Hx of allergy to Phenobarbital - unknown reaction
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt vaccinated with MMR developed joint stiffness & soreness, slight bruising at inject site, rash which was described as itchy, no redness or swelling.


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