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This is VAERS ID 40391

Case Details

VAERS ID: 40391 (history)  
Form: Version 1.0  
Age: 0.6  
Sex: Male  
Location: Mississippi  
Vaccinated:1992-02-20
Onset:1992-02-20
   Days after vaccination:0
Submitted: 1992-03-10
   Days after onset:19
Entered: 1992-03-19
   Days after submission:9
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 304924 / 2 RL / -
HEP: HEP B (FOREIGN) / MERCK & CO. INC. 1294T / 3 LL / -
HIBV: HIB (HIBTITER) / PFIZER/WYETH M155HJ / 2 LL / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 304925 / 2 MO / PO

Administered by: Public       Purchased by: Public
Symptoms: Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), 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? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: well child imporved from ear infect
Preexisting Conditions: pt had cold, ear infect;
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type: MS9205

Write-up: Mom states pt had fine red rash across face/trunk/inc temp x 2-3 days; Onset 24FEB-27FEB92 rash; Onset inc temp 20FEB - 24FEB92;


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