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This is VAERS ID 39564

Case Details

VAERS ID: 39564 (history)  
Form: Version 1.0  
Age: 1.4  
Sex: Male  
Location: Arizona  
Vaccinated:1992-01-10
Onset:1992-01-21
   Days after vaccination:11
Submitted: 1992-01-31
   Days after onset:10
Entered: 1992-02-18
   Days after submission:18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0887T / 3 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. H56T / 2 - / IM

Administered by: Public       Purchased by: Public
Symptoms: Convulsion, Diarrhoea, Otitis media, Pyrexia, Rhinitis
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Pseudomembranous colitis (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), 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? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: URI
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CBC-WNL;
CDC Split Type: AZ9209

Write-up: Pt recvd MMR/HIB on 10JAN92 & on 20JAN92 devel rhinorrhea & fever; On 21JAN temp rose to 104 @ 4AM had a generalized sz x 3 mins; then @ 1145AM had another generalized sz lasting 2 mins; pt also had some loose stools; pt had no further sz;


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