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This is VAERS ID 25887

Case Details

VAERS ID: 25887 (history)  
Form: Version 1.0  
Age: 2.0  
Sex: Male  
Location: Indiana  
Vaccinated:1990-08-31
Onset:1990-09-01
   Days after vaccination:1
Submitted: 1990-09-07
   Days after onset:6
Entered: 1990-09-11
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES A021092 / UNK - / A
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1501S / UNK - / A
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0618L / 3 MO / PO

Administered by: Private       Purchased by: Private
Symptoms: Convulsion
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CBC normal except deficiency, glucose normal , electrolytes normal, cat normal
CDC Split Type:

Write-up: Pt vaccinated with MMR/HIB/OPV developed febrile seizure requiring hospital admission approx 24 hrs after vax. /w HIB, MMR, & oral Polio. Released next day & only treament was observation.


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