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This is VAERS ID 123185

Case Details

VAERS ID: 123185 (history)  
Form: Version 1.0  
Age: 1.4  
Sex: Female  
Location: New York  
Vaccinated:1995-02-10
Onset:1995-02-20
   Days after vaccination:10
Submitted: 1999-05-26
   Days after onset:1555
Entered: 1999-06-01
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 1 - / -

Administered by: Other       Purchased by: Other
Symptoms: Aplastic anaemia, Encephalitis, Infection, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Agranulocytosis (narrow), Haematopoietic cytopenias affecting more than one type of blood cell (narrow), Haematopoietic erythropenia (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (narrow), Hypersensitivity (narrow), Myelodysplastic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: roseola type virus,fever,rash p/ MMR #1~ ()~~~In patient
Other Medications: unk
Current Illness:
Preexisting Conditions: fever;viral exanthema;
Allergies:
Diagnostic Lab Data:
CDC Split Type: WAES99051409

Write-up: pt recv vax & became ill 10 days p/vax;pt had a viral synd which devel into encephalitis & was hosp;pt then devel aplastic anemia & dx w/Dubowitz synd;pt had recurrence of aplastic anemia;pt died


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