|
| VAERS ID |
25131 |
Vaccination Date: |
1990-06-25 |
| Age |
18.0 |
Date filed: 1990-07-17 |
| Sex |
F |
Where Administered: |
UNK |
| State |
CT |
Purchased by: |
UNK |
|
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No |
| ER or Doctor Visit? No |
| Hospitalized? No |
| Current Illness: |
| Diagnostic Lab Data: |
| Previous Vaccinations: |
| Other Medications: |
| Preexisting Conditions: |
|
| |
Vaccinations |
Manufacturer |
Lot |
Dose |
Route |
Site |
| 1 |
MMR |
MSD |
2130R |
|
|
|
|
| Onset Date: 1990-06-28 Number of Days: 3 |
| Symptoms: ARTHRALGIA ASTHENIA FEVER |
| Fever of 102 F, achy joints, fatigue |
|
|
| VAERS ID |
25514 |
Vaccination Date: |
0000-00-00 |
| Age |
44.7 |
Date filed: 1990-07-19 |
| Sex |
F |
Where Administered: |
PVT |
| State |
NY |
Purchased by: |
UNK |
|
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No |
| ER or Doctor Visit? No |
| Hospitalized? No |
| Current Illness: |
| Diagnostic Lab Data: |
| Previous Vaccinations: |
| Other Medications: |
| Preexisting Conditions: Allergic to pencillin, no rxn to
eggs, |
|
| |
Vaccinations |
Manufacturer |
Lot |
Dose |
Route |
Site |
| 1 |
MMR |
MSD |
1732R |
|
SC |
|
|
| Onset Date: 1990-05-21 Number of Days: |
| Symptoms: ASTHMA EDEMA FACE TACHYCARDIA |
| Pt was noticed to have swelling of the eyelids, was found to have
bilateral wheezing & tachycardia. There was no rxn to the 1st MMR
received. |
|
|
| VAERS ID |
25572 |
Vaccination Date: |
1990-01-26 |
| Age |
42.0 |
Date filed: 1990-07-25 |
| Sex |
F |
Where Administered: |
PVT |
| State |
MA |
Purchased by: |
UNK |
|
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No |
| ER or Doctor Visit? No |
| Hospitalized? No |
| Current Illness: |
| Diagnostic Lab Data: |
| Previous Vaccinations: |
| Other Medications: |
| Preexisting Conditions: none |
|
| |
Vaccinations |
Manufacturer |
Lot |
Dose |
Route |
Site |
| 1 |
MMR |
MSD |
2358R |
|
SC |
|
|
| Onset Date: 1990-02-07 Number of Days: 12 |
| Symptoms: ARTHRALGIA RASH |
| Immediately /p developed a facial rash, also developed joint pain in
the 4th PIP dorsal & mid wrist of rt hand on week post shot. |
|
|
| VAERS ID |
25575 |
Vaccination Date: |
1990-01-23 |
| Age |
25.0 |
Date filed: 1990-07-26 |
| Sex |
F |
Where Administered: |
PVT |
| State |
MA |
Purchased by: |
UNK |
|
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No |
| ER or Doctor Visit? No |
| Hospitalized? No |
| Current Illness: |
| Diagnostic Lab Data: |
| Previous Vaccinations: |
| Other Medications: |
| Preexisting Conditions: |
|
| |
Vaccinations |
Manufacturer |
Lot |
Dose |
Route |
Site |
| 1 |
MMR |
MSD |
|
|
SC |
|
|
| Onset Date: 1990-02-03 Number of Days: 11 |
| Symptoms: LYMPHADENO MALAISE |
| Pt had 2-3 days of inlarged ant. cervical lymph nodes & body aches.
Subsided without sequelae, Pt not seen in HS until 12Apr90. No enlarged
nodes at this time. |
|
|
| VAERS ID |
25611 |
Vaccination Date: |
1990-06-29 |
| Age |
18.0 |
Date filed: 1990-07-31 |
| Sex |
M |
Where Administered: |
PVT |
| State |
MD |
Purchased by: |
UNK |
|
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No |
| ER or Doctor Visit? No |
| Hospitalized? Yes (days in hospital: ) |
| Prolonged Hospitalization? Yes |
| Current Illness: |
| Diagnostic Lab Data: ECG revealed changes consistent /w a
recurrence of pericarditis |
| Previous Vaccinations: |
| Other Medications: |
| Preexisting Conditions: medical history of pericarditis |
|
| |
Vaccinations |
Manufacturer |
Lot |
Dose |
Route |
Site |
| 1 |
MMR |
MSD |
409672130R |
|
|
|
|
| Onset Date: 1990-06-30 Number of Days: 1 |
| Symptoms: HEART BLOCK PAIN CHEST PERICARDITIS |
| Pt developed chest pains and other signs of pericarditis including a
pericardial friction rub, hospitalized |
|
|