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This is VAERS ID 590899

Case Details

VAERS ID: 590899 (history)  
Form: Version 1.0  
Age: 1.01  
Gender: Male  
Location: Vermont  
Vaccinated:2015-08-07
Onset:2015-08-10
   Days after vaccination:3
Submitted: 2015-08-12
   Days after onset:2
Entered: 2015-08-18
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. K016154 / 1 LL / SC
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH L53937 / 4 LL / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. L001326 / 1 RL / SC

Administered by: Private       Purchased by: Public
Symptoms: Erythema multiforme, Rash generalised
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (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? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: MMR, VARIVAX and PREVNAR given Thursday. Monday night without other signs of illness developed a rash. Tuesday morning I saw him an it covered his entire body and was clearly erythema multiforme.


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