Page breadcrumb nav

VAERS Report 2157191

Case Report Section

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