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This is VAERS ID 39747

Case Details

VAERS ID: 39747 (history)  
Form: Version 1.0  
Age: 0.5  
Sex: Female  
Location: Hawaii  
Vaccinated:1991-12-17
Onset:1991-12-17
   Days after vaccination:0
Submitted: 1991-12-23
   Days after onset:6
Entered: 1992-03-02
   Days after submission:70
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 304922 / 3 RL / -
HEP: HEP B (FOREIGN) / MERCK & CO. INC. 0169T / 2 LL / -
HIBV: HIB (HIBTITER) / PFIZER/WYETH M125HF / 3 LL / -

Administered by: Public       Purchased by: Public
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), 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? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: runny nose past 3 days
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CXR, Blood test
CDC Split Type: HI9207

Write-up: Pt devel t102 fever aobut 5PM on day of immun which continued throughout next 48 hrs inspite of APAP, liquids, & frequent warm showers; Seen by MD 19DEC91 fever continued elevating to 104.8 & revisited MD; exam by MD 20DEC91 CXR & lab work;


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