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This is VAERS ID 124936

(NOTE: This result is from the 12/31/2003 version of the VAERS database)

Case Details

VAERS ID: 124936 (history)  
Form: Version .0  
Age: 1.0  
Sex: Female  
Location: Georgia  
Vaccinated:1999-05-24
Onset:1999-06-01
   Days after vaccination:8
Submitted: 1999-06-15
   Days after onset:14
Entered: 1999-06-21
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II / MSD 1357H / 0 RA / SC
OPV: ORIMUNE / LEDERLE 0798D / 2 - / PO

Administered by: Public       Purchased by: Unknown
Symptoms: APNEA, COAGUL DIS, CONVULS GRAND MAL, EDEMA BRAIN, EDEMA LUNG
SMQs:

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 1999-06-01
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 6/1/99, 1:30pm laid down for nap as usual; woke up at 4:05 w/ fever & seizures; called EMS; to hosp by ambulance still having seizures; died at 6:58pm; according to papers from the health dept severe rxn from MMR will happen w/ fever, sz


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