National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 27661

Case Details

VAERS ID: 27661 (history)  
Form: Version 1.0  
Age: 1.3  
Sex: Male  
Location: Georgia  
Vaccinated:1990-12-10
Onset:1990-12-19
   Days after vaccination:9
Submitted: 1990-12-31
   Days after onset:12
Entered: 1991-01-30
   Days after submission:30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 281945 / 4 LA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1229S / 1 RA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0619D / 3 MO / PO

Administered by: Public       Purchased by: Public
Symptoms: Dyspnoea, Gaze palsy, Pyrexia, Rash, Tremor, Vasodilatation
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Ocular motility disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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: pt vaccinated w/HBCV, PRAXIS, M670FC, IM, LA, 0, 12DEC90. Also tempra
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: GA9026

Write-up: 19DEC90 approx 415PM grunting, eyes rolled back, trembling all over, difficulty breathing, hot. Lasted approx 8 min. White blood count -good, temp 104, lt ear red.


New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=27661


Copyright © 2019 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166