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The following is all the information available on report# VAERS_ID: 740059
Vaccine(s) were received on 05/17/2016
Vaccine(s) were received in the state: WA
At the time of vaccination, patient was : 1 of age
Patient sex : M
Reaction was life threatening?: N
Patient eventually recovered from reaction ?: N
Patient eventually died?: N

The following Lab Data for this case is available: Blood tests done 08/03/2016

The following Data for this patients HISTORY is available: Asthma, and Autism

The following Data for this patients ALLERGIES is available: [None ]

Description of adverse reaction: Second day after shot child was lethargic, irritable, decreased appetite, and decreased awareness. Before vaccine child was very active and interacted with us. Child's health began to deteriorate after vaccine was administered. At child's fifteen month wellness check up nurse ordered blood tests for child to find out why child was so weak and not recovering from current illnesses.


Vaccine(s) associated with report# 740059

TypeNameManufacturerVaccine LOT #Dose SeriesROUTESite
MMRVMEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD) MERCK & CO. INC.L0292661IMRL

Symptoms(s) associated with report# 740059

Altered state of consciousness
Asthenia
Blood test
Decreased appetite
General physical health deterioration
Irritability
Lethargy