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This is VAERS ID 39339

Case Details

VAERS ID: 39339 (history)  
Form: Version 1.0  
Age: 1.3  
Sex: Male  
Location: Washington  
Vaccinated:1992-01-06
Onset:1992-01-09
   Days after vaccination:3
Submitted: 1992-01-10
   Days after onset:1
Entered: 1992-02-04
   Days after submission:25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH M160HH / UNK - / IM A
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1368T / 1 - / SC A

Administered by: Private       Purchased by: Unknown
Symptoms: Convulsion, Febrile convulsion, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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, 2 days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: LP, BC
CDC Split Type: WA92676

Write-up: 3 days p/vax fever & vomiting 24 hrs later sz requiring admission to hosp;


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