Vaer Report Details
Age: NA
Gender: Female
State: Outside US
- Patient Died?
- No
- Vaccine information
-
Name: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD)
Type: Measles, mumps, rubella and varicella vaccine live
Manufacturer: MERCK & CO
Lot: u017056
- Date report was received
- 2022-03-04
- Date form completed
- Date Vaccinated
- 2021-09-15
- Date of Onset
- 3
- Number of days (onset date – vaccination date)
- 3
- Adverse Event Description
-
fever over or equal 39.5; information has been downloaded from regulatory agency (it-minisal02-833886). this spontaneous report was received from an other health professional and refers to a 1-year-old female patient. no medical history, concurrent conditions, concomitant therapies, previous events/allergies were provided. on 15-sep-2021, the patient was vaccinated with measles, mumps, rubella and varicella (oka-merck) virus vaccine live (rha)(proquad) subcutaneously in deltoid as an inoculation site, lot #u017056, expiration date was not provided, upon internal review, it was established as 31-oct-2022 (dose, concentration, dose number were not reported) indication was not reported, established as prophylaxis. on 18-sep-2021, the patient experienced fever over or equal 39.5. the outcome of fever was reported as recovered on 20-sep-2021. the agency did not provide causality assessment between the event and suspect vaccine. follow-up information has been downloaded from regulatory agency (it-minisal02-833886) on 24-feb-2022. event seriousness were updated to ime and also severity is updated to severe
- Lab Data
-
na
- List of symptoms
-
pyrexia
- Patient Died?
- No
- Date Died
- NA
- Birth defect
- false
- Vaccine Administered By:
- Unknown
- Vaccine Purchased By:
- Unknown
- Patient visit ER?
- No
- Patient Hospitalized?
- No
- Stay in hospital
- No
- Days in hospital
- Unspecified
- Permanent disability?
- No
- Allergies:
-
na
- Current Illness
-
na