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This is VAERS ID 30060

Case Details

VAERS ID: 30060 (history)  
Form: Version 1.0  
Age: 1.3  
Sex: Male  
Location: Minnesota  
Vaccinated:1991-03-26
Onset:1991-03-27
   Days after vaccination:1
Submitted: 1991-04-18
   Days after onset:21
Entered: 1991-04-22
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH M685EN / UNK RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1929S / UNK LL / SC

Administered by: Private       Purchased by: Unknown
Symptoms: Convulsion, Diarrhoea, Muscle twitching, Stupor, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Pseudomembranous colitis (broad), Dyskinesia (broad), Dystonia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Generalised convulsive seizures following immunisation (narrow), Noninfectious diarrhoea (narrow), 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: Normal EEG, Normal CT SCAN, Normal Blood work, Lytes, CA Gluc, Mg
CDC Split Type:

Write-up: 4hrs post vax developed v, d 6x each between 6PM & 7AM; no fever, febrile sz, arched back legs stiff no clonus, eye dilated & "empty look", ? lt cheek & lt arm twitching;


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