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This is VAERS ID 42794

Case Details

VAERS ID: 42794 (history)  
Form: Version 1.0  
Age: 1.3  
Sex: Male  
Location: Pennsylvania  
Vaccinated:1992-05-29
Onset:1992-06-04
   Days after vaccination:6
Submitted: 1992-06-08
   Days after onset:4
Entered: 1992-06-12
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH M070HP / 4 RA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1941T / 1 LA / SC

Administered by: Private       Purchased by: Private
Symptoms: Apnoea, Cardiac arrest, Convulsion, Cyanosis, Muscle twitching, Pyrexia
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Convulsions (narrow), Dyskinesia (broad), Dystonia (broad), Acute central respiratory depression (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Respiratory failure (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? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: heart murmur
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Began 29MAY w/elevated temp; 30MAY & 31MAY t101.6 & above; 01JUN afebrile; 4JUN had sz (extremity upper) & facial twitching x 1 1/2min @ 810AM; gave CPR as pt lips cyanotic & apneic spell;


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