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This is VAERS ID 179416

Case Details

VAERS ID: 179416 (history)  
Form: Version 1.0  
Age: 4.0  
Sex: Male  
Location: Unknown  
Vaccinated:1998-01-01
Onset:0000-00-00
Submitted: 2001-12-20
Entered: 2001-12-27
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / SC

Administered by: Other       Purchased by: Other
Symptoms: Encephalitis, Neurodevelopmental disorder
SMQs:, Noninfectious encephalitis (narrow), 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? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data:
CDC Split Type: WAES0112USA01104

Write-up: Information has been received from a physician for a case in litigation concerning a 7 year old male who in approximately 1998 was vaccinated with MMR II, also referred to as the "triple measles vaccine" by the physician. The pt presented with a history of recent psychomotor retardation without any associated history or signs of an infectious or neoplastic process. Investigation concluded that the etiology lay in a subacute sclerosing panencephalitic process attributable to the MMR II. The pt manifested no allergies to egg protein and his immediate post vaccination course had been uneventful. There had been no evidence of measles prior to the vaccination and his psychomotor development had been normal until the onset of symptoms. Subsequently, in approximately August 2001 the pt died.


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