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This is VAERS ID 42838

Case Details

VAERS ID: 42838 (history)  
Form: Version 1.0  
Age: 1.4  
Sex: Female  
Location: Utah  
Vaccinated:1992-03-16
Onset:1992-03-16
   Days after vaccination:0
Submitted: 1992-03-17
   Days after onset:1
Entered: 1992-06-15
   Days after submission:89
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 314960 / 4 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M160HH / 4 RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1714S / 1 RA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 312918 / 3 MO / PO

Administered by: Public       Purchased by: Public
Symptoms: Dyspnoea, Leukocytosis, Pneumonia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: asthma
Allergies:
Diagnostic Lab Data: 17MAR92 6AM WBC 32,000;
CDC Split Type: UT920013

Write-up: 16MAR92 pt recvd DTP/OPV/MMR/HIB a/noon; 8PM pt was exp difficulty breathing; had a prev dx of asthma, taken to local ER; not responding to tx for astham; later life-flighted to hosp x 3 days; 17MAR92 WBC 32,000; dx pneumonia;


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