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This is VAERS ID 31540

Case Details

VAERS ID: 31540 (history)  
Form: Version 1.0  
Age: 1.3  
Sex: Female  
Location: Georgia  
Vaccinated:1991-01-21
Onset:1991-02-01
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 1991-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0560S / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Face oedema, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Haemophilus B vax Lot#-OC21132;given on 21Jun91
Current Illness:
Preexisting Conditions: No relevant hx
Allergies:
Diagnostic Lab Data: Platelet count - 55100
CDC Split Type: WAES91020310

Write-up: 21jan91 pt vax w/ MMR + H. flu vax; 01Feb91 devel erythematous rash over trunk + arms. 02Feb91 devel fever + rash worsened which caused swelling of face. Tx w/ Benadryl + APAP. 04Feb91 fever 103F. Pt hosp + 05Feb rash turned purple.


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