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This is VAERS ID 46017

Case Details

VAERS ID: 46017 (history)  
Form: Version 1.0  
Age: 1.5  
Sex: Female  
Location: South Carolina  
Vaccinated:1992-03-17
Onset:1992-03-17
   Days after vaccination:0
Submitted: 1992-09-21
   Days after onset:187
Entered: 1992-10-05
   Days after submission:14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 320905 / 4 LL / -
HIBV: HIB (HIBTITER) / PFIZER/WYETH M695HL / 3 RL / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1987T / 1 RL / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 314934 / 3 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? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE x/sl cold no fever
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NA
CDC Split Type: SC92121

Write-up: pt had elevated temp p/last vax; hospitalized x 5 days; mom states temp went as high as 114; MD said hospitalization could be related to vax reaction;


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