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This is VAERS ID 28434

Case Details

VAERS ID: 28434 (history)  
Form: Version 1.0  
Age: 1.3  
Sex: Female  
Location: Colorado  
Vaccinated:1990-12-17
Onset:1990-12-30
   Days after vaccination:13
Submitted: 1991-01-22
   Days after onset:23
Entered: 1991-02-25
   Days after submission:34
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH M030FC / 1 - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0896S / 1 - / -

Administered by: Public       Purchased by: Public
Symptoms: Cellulitis, Conjunctivitis, Eye disorder, Infection
SMQs:, Severe cutaneous adverse reactions (broad), Corneal disorders (broad), Retinal disorders (broad), Conjunctival disorders (narrow), Ocular infections (broad), Hypersensitivity (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, 3 days
   Extended hospital stay? No
Previous Vaccinations: none~ ()~~~In patient
Other Medications:
Current Illness: none
Preexisting Conditions: hx of recurring otitis;croup
Allergies:
Diagnostic Lab Data: blood cultures
CDC Split Type: CO916

Write-up: Lt eye swelling /w rapid progression on 31Dec. Taken to ER & subsequently hospitalized /w orbital cellulitis. Blood cultures showed hemophaelis influenzae


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