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This is VAERS ID 29744

Case Details

VAERS ID: 29744 (history)  
Form: Version 1.0  
Age: 1.5  
Sex: Female  
Location: Michigan  
Vaccinated:1991-03-07
Onset:1991-03-16
   Days after vaccination:9
Submitted: 1991-03-25
   Days after onset:9
Entered: 1991-04-05
   Days after submission:11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1711S / 1 RL / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 291946 / 3 MO / PO

Administered by: Public       Purchased by: Public
Symptoms: Anorexia, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: CXR=bronchialitis, loose infiltrates
CDC Split Type: MI9118

Write-up: MMR admit approx 2 wks,approx 9 days following MMR inject.developed a generalized rash & T of 104, T lasted 3 days then on 21Mar91 T remained.Admitted to hosp on 21Mar91 /w T of 105.6.Demonstrates loss of appetite.


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