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This is VAERS ID 41629

Case Details

VAERS ID: 41629 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Female  
Location: Pennsylvania  
Vaccinated:1992-04-22
Onset:1992-04-22
   Days after vaccination:0
Submitted: 1992-04-23
   Days after onset:1
Entered: 1992-04-29
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 1F31022 / 1 LL / -
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0229V / 1 RL / -
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0600593 / 1 RL / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 651K5 / 1 MO / PO

Administered by: Private       Purchased by: Private
Symptoms: Crying, Pallor, Pyrexia, Screaming, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Depression (excl suicide and self injury) (broad), Hypotonic-hyporesponsive episode (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? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: Noted to be pale p/nap (several hrs p/vax); Had high pitched cry off & on for several hrs; vomited p/nursing, t100.6;


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