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VAERS Report 2157191

Case Report Section

Détails du rapport Vaer

Âge: N/A

Genre: Female

Région : Outside US

Patient décédé?
Non
Renseignements sur les vaccins

Nom: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD)

Type : Measles, mumps, rubella and varicella vaccine live

Fabricant: MERCK & CO

Lot: u017056


Date de réception du rapport
2022-03-04
Date à laquelle le formulaire est complèté
Date de vaccination
2021-09-15
Date d’apparition
3
Nombre de jours (date d’apparition – date de vaccination)
3
Description de l’événement indésirable

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

Données de laboratoire
na
Liste des symptômes
pyrexia
Patient décédé?
Non
Date de décès
N/A
Anomalie congénitale
false
Vaccin administré par :
Unknown
Vaccin acheté par :
Inconnu
Visite d’un patient à l’urgence?
Non
Patient hospitalisé?
Non
Séjour à l’hôpital
Non
Nombre de jours à l’hôpital
Non spécifié
Invalidité permanente?
Non
Allergies:
na
Maladie actuelle
na