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This is VAERS ID 37279

Case Details

VAERS ID: 37279 (history)  
Form: Version 1.0  
Age: 1.1  
Sex: Male  
Location: New Jersey  
Vaccinated:1991-05-09
Onset:1991-05-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1992-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0763T / 1 - / IM

Administered by: Private       Purchased by: Private
Symptoms: Convulsion, 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), 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? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES91050941

Write-up: Pt recvd MMR vax 9MAY91 & approx 1 hr following pt devel sz w/a fever; pt was hospitalized for sepsis work-up & was discharged as well 24 hrs later; no further details were provided;


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