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This is VAERS ID 45010

Case Details

VAERS ID: 45010 (history)  
Form: Version 1.0  
Age: 0.4  
Sex: Male  
Location: South Carolina  
Vaccinated:1992-07-14
Onset:1992-07-14
   Days after vaccination:0
Submitted: 1992-09-09
   Days after onset:57
Entered: 1992-09-15
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 330912 / 2 RL / IM
HEP: HEP B (FOREIGN) / MERCK & CO. INC. 0104V / 1 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M695HL / 2 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 324939 / 2 MO / PO

Administered by: Public       Purchased by: Unknown
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC Split Type: SC92109

Write-up: mom states beginning 14JUL92 PM pt had t103 R; APAP given w/mild relief of temp but elevated again w/in 4 hrs to 103; temp stable by day #2 PM; MD advised to withold Pertussis;


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