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This is VAERS ID 29808

Case Details

VAERS ID: 29808 (history)  
Form: Version 1.0  
Age: 1.3  
Sex: Male  
Location: Illinois  
Vaccinated:1991-03-01
Onset:1991-03-07
   Days after vaccination:6
Submitted: 1991-03-13
   Days after onset:6
Entered: 1991-04-08
   Days after submission:25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0A21092 / 1 RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1498S / 1 RA / SC

Administered by: Public       Purchased by: Public
Symptoms: Agitation, Apnoea, Cough, Cyanosis, Febrile convulsion, Pyrexia, Rhinitis
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Acute central respiratory depression (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Respiratory failure (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, 3 days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Hx of infectious diseases- etc otitis media w/fever- URI & early bronchitis;
Allergies:
Diagnostic Lab Data: WBC 2900, 62lymphs, 36 segs; SGOT mildly elevated 52; chem 6;
CDC Split Type: IL9117

Write-up: 15mo old began having a febrile illness approx 8 days p/receiving his 1st MMR/HIB vax; temp to 102(ax) & febrile convuls; 2 days prior to admission pt began having sx of URI w/rhinitis, cough, congestion & fever worse apneic & cyanotic;


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