VAERS ID: 25004

AGE: 0.9| SEX: M|STATE: NY (United States)

Description

Pt developed chills for approx. 1 hr, felt achy all over, genital area turned red with some swelling, no pain 24 hrs later, now has pain in genital area. Genitals pain, swelling, redness for 8 days. Fever, dematitis contact, rigors

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Symptoms

Chills, Dermatitis contact, Oedema genital, Pelvic pain

Vaccines

VAX DATE: 11-13-1989| ONSET DATE: 11-13-1989| DAYS TO ONSET: 0
NameDose #TypeManufacturerLotRouteSite
POLIO VIRUS, ORAL (ORIMUNE) Unknown OPV PFIZER\WYETH 232961 Unknown Unknown

RECVDATE:07-02-1990
RPT_DATE:
CAGE_YR:
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:U
LAB_DATA:
V_ADMINBY:
OTHER_MEDS:
CUR_ILL:
HISTORY:
PRIOR_VAX:~ ()~~~In patient
SPLTTYPE:890269201
FORM_VERS:
TODAYS_DATE:
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:
V_FUNDBY:

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