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This is VAERS ID 26959

Case Details

VAERS ID: 26959 (history)  
Form: Version 1.0  
Age: 33.0  
Sex: Female  
Location: California  
Vaccinated:1990-11-09
Onset:1990-11-18
   Days after vaccination:9
Submitted: 1990-12-03
   Days after onset:15
Entered: 1990-12-11
   Days after submission:8
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 2131R / UNK - / SC
TD: TD ADSORBED (NO BRAND NAME) / PFIZER/WYETH 498061 / UNK - / IM

Administered by: Private       Purchased by: Private
Symptoms: Pain, Pharyngitis, Pyrexia
SMQs:, Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt vaccinated with TD/MMR developed body aches, fever x 4 days. Sore throat.


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