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This is VAERS ID 28173

Case Details

VAERS ID: 28173 (history)  
Form: Version 1.0  
Age: 1.8  
Sex: Female  
Location: Alabama  
Vaccinated:1989-10-23
Onset:1989-10-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1991-02-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 256962 / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1661R / UNK - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 253944 / UNK MO / PO

Administered by: Unknown       Purchased by: Unknown
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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: No hx of convuls in pt, hx of convuls in siblings & parents unknown.
Allergies:
Diagnostic Lab Data: EEG; Brain Scan: Lumbar Puncture - Normal
CDC Split Type: 900165901

Write-up: CDC reports: 21 mo child had convuls following DTP/OPV/MMR. Hospitalized 2 days. EEG, Brain Scan, Lumbar Puncture - normal.


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