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This is VAERS ID 28149

Case Details

VAERS ID: 28149 (history)  
Form: Version 1.0  
Age: 1.4  
Sex: Female  
Location: Louisiana  
Vaccinated:1990-01-24
Onset:1990-01-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1991-02-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 256965 / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 2064P / UNK - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0542B / UNK MO / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Convulsion, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (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? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: No illness following previous immunizations, no hx of convuls in pt, siblings, or parents.
Allergies:
Diagnostic Lab Data: EEG-WNL
CDC Split Type: 900163003

Write-up: 17 mo child developed fever to 103 & four convulsive episodes following DTP/OPV/MMR immunization. Hospitalized, EEG within normal limits according to pt mom. Pt on no anti-sz meds, duration of illness 4 days.


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