| VAERS ID: |
25140 (history) |
| Form: |
Version 1.0 |
| Age: |
|
| Sex: |
Female |
| Location: |
Illinois |
| Vaccinated: | 1989-10-11 |
| Onset: | 1989-10-11 |
| Days after vaccination: | 0 |
| Submitted: |
0000-00-00 |
| Entered: |
1990-07-09 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES |
256961 / UNK |
- / IM |
Administered by: Private Purchased by: Private
Symptoms: Agitation,
Apnoea,
Hypotension,
Hypotonia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Respiratory failure (narrow), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: 8902436.01
Write-up: PT CRANKY NEXT 48 HRS AFTER IMMUN. BECAME LIMP AFTER 48 HRS. 3 EPISODES IN 3-4 HRS;MOTHER THOUGHT PT STOPPED BREATHING-NO COLOR CHANGE, NO SEIZURES, HOSPITALIZED-ABNORMAL PNEUMOGRAM. PT IMPROVED |
