This is VAERS ID 90090
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| VAERS ID: | 90090 (history) | Vaccinated: | 1994-11-30 | | Age: | 2.9 | Onset: | 1994-12-01, Days after vaccination: 1 | | Gender: | Male | Submitted: | 1996-09-17, Days after onset: 655 | | Location: | Connecticut | Entered: | 1996-09-23, Days after submission: 6 | |
| Life Threatening? No |
| Died? No |
| Permanent Disability? Yes |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Previous Vaccinations: | | Other Medications: ATB-Amoxicillin;Vantin, Augmentin | | Current Illness: ear infect from OCT through DEC94 | | Preexisting Conditions: MD ped allergies-allergy to cat hair, clust & mold | | Diagnostic Lab Data: | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HIBV: HIB (HIBTITER) | LEDERLE PRAXSIS | M290LC | 3 | | A | | MMR: MEASLES + MUMPS + RUBELLA (MMR II) | MERCK & CO. INC. | 0968A | 0 | | A | | OPV: POLIO VIRUS, ORAL (ORIMUNE) | LEDERLE LABORATORIES | 384949 | 2 | PO | | |
| Administered by: Private Purchased by: Other | Symptoms: Autism,
Hypotonia,
Infection,
Mental retardation severity unspecified,
Personality disorder
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Hostility/aggression (broad), Hypotonic-hyporesponsive episode (broad)
| | Write-up: loss of words, loss of eye contact, inc toe walking, hand flapping;inappropriate laughing, temper tantrums biting of clothing, repetition of words-no meaning;tx vitamin B-minerals;dx autism M.S.D.D.; |
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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=90090
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