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This is VAERS ID 46019

Case Details

VAERS ID: 46019 (history)  
Form: Version 1.0  
Age: 1.3  
Sex: Female  
Location: Illinois  
Vaccinated:1992-07-30
Onset:1992-08-02
   Days after vaccination:3
Submitted: 1992-09-28
   Days after onset:57
Entered: 1992-10-05
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH M665HH / 4 RL / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0495V / 1 LL / -

Administered by: Private       Purchased by: Private
Symptoms: Febrile convulsion, Otitis media, Pharyngitis
SMQs:, Agranulocytosis (broad), Convulsions (narrow), Oropharyngeal infections (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), 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, ? days
   Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: prior hx of febrile seizure 31MAR92
Allergies:
Diagnostic Lab Data: EEG
CDC Split Type:

Write-up: Pt had febrile seizure x 2; also had OM & pharyngitis @ same time; adm to hosp for further rx & dx complex febrile seizure about 12 minutes in duration;


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