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This is VAERS ID 41777

Case Details

VAERS ID: 41777 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Male  
Location: Hawaii  
Vaccinated:1992-05-01
Onset:1992-05-01
   Days after vaccination:0
Submitted: 1992-05-01
   Days after onset:0
Entered: 1992-05-06
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 2G31010 / 1 LL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0310V / 1 RL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M155HN / 1 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 647F / 1 MO / PO

Administered by: Private       Purchased by: Private
Symptoms: Agitation, Dyspnoea, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Cardiomyopathy (broad), 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? No
Previous Vaccinations: NA~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: Unusual breathing pattern; unusual fussiness; fever;


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