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This is VAERS ID 27074

Case Details

VAERS ID: 27074 (history)  
Form: Version 1.0  
Age: 1.3  
Sex: Female  
Location: Mississippi  
Vaccinated:1990-11-15
Onset:1990-11-15
   Days after vaccination:0
Submitted: 1990-11-19
   Days after onset:4
Entered: 1990-12-17
   Days after submission:28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 285967 / 4 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0016S / 1 RL / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 283939 / 3 MO / PO

Administered by: Public       Purchased by: Public
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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, 2 days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: MS904

Write-up: Pt vaccinated w/DTP/OPV/MMR developed temp during night after injection called clinic referred to ER. admitted to hosp & placed under seizure precautions.


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