National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 28852

Case Details

VAERS ID: 28852 (history)  
Form: Version 1.0  
Age: 1.3  
Sex: Male  
Location: Pennsylvania  
Vaccinated:1990-11-13
Onset:1990-11-21
   Days after vaccination:8
Submitted: 1991-02-12
   Days after onset:83
Entered: 1991-03-06
   Days after submission:22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 283914 / 4 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0213S / 1 RA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0612C / 3 MO / PO

Administered by: Public       Purchased by: Public
Symptoms: Convulsion, Gaze palsy, Otitis media, 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), Ocular motility disorders (narrow), 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? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations: none~ ()~~~In patient
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: all normal/negative blood tests(CBC, electrolytes, blood glucose, BUN, blood cultures, spinal tap
CDC Split Type: PA9145

Write-up: Day of vax dev 101 F over 1st 24 hrs,controlled /w APAP & resolved /p 1 day, well until 21Nov90 dev T 103.5 lasted through nite,Called MD 22Nov90 said"prob from MMR"@ 10 am eyes rolled back &had sz,to ER & dx Lt OM. Had T since w/o sz.


New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=28852


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