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This is VAERS ID 39042

Case Details

VAERS ID: 39042 (history)  
Form: Version 1.0  
Age: 1.3  
Sex: Female  
Location: North Carolina  
Vaccinated:1991-07-02
Onset:1992-01-06
   Days after vaccination:188
Submitted: 1992-01-15
   Days after onset:9
Entered: 1992-01-27
   Days after submission:12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH M660HC / 2 RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0885T / 1 - / SC

Administered by: Private       Purchased by: Private
Symptoms: Drug ineffective, Infection, Meningitis, Pyrexia, Somnolence, Vomiting
SMQs:, Acute pancreatitis (broad), Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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, 10 days
   Extended hospital stay? No
Previous Vaccinations: NA~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: HEALTHY
Allergies:
Diagnostic Lab Data: LP-3000 WBC H. flu; BC positive for H. Flu
CDC Split Type: 920010301

Write-up: Pt was vaxed w/HIBTITTER @ 9mos of age & given 2nd dose @ 15mos of age; approx 6 mos later, exp high fever, vomiting & lethargy; hospitalized; dx H. Flu Meningitis; tx included IV Rocephin & Steroids x 10 days;


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