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From the 9/10/2021 release of VAERS data:

This is VAERS ID 245395



Case Details

VAERS ID: 245395 (history)  
Form: Version 1.0  
Age: 1.73  
Sex: Female  
Location: Florida  
Vaccinated:2005-08-26
Onset:0000-00-00
Submitted: 2005-10-12
Entered: 2005-10-14
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2253AA / UNK LL / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Abnormal behaviour, Autism, Crying, Facial dysmorphism, Irritability, Listless, Pyrexia, Screaming
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Congenital, familial and genetic disorders (narrow), Psychosis and psychotic disorders (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Depression (excl suicide and self injury) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: fever, crying, listlessness~Measles + Mumps + Rubella (no brand name)~~1.00~In Patient
Other Medications:
Current Illness:
Preexisting Conditions: Pt''s mom states that her daughter had 3 doses of Tripedia at ages 2, 4 and 6 months. She showed signs of Autism at 7 months of age. At 12 months they had her hearing checked because she was ignoring her mom and dad. The pt''s hearing is good. Pt received MMR dose one at 12 months of age and experienced crying, fever and listlessness which was never reported.
Allergies:
Diagnostic Lab Data:
CDC Split Type: 200501988

Write-up: Initial report received from a consumer on 04Oct05. A mother reported that her 22 month old daughter had inconsolable crying (1/2 hr episodes at a time), showed signs of being easily frustrated, began spinning in circles, had facial contortions, showed hand gesturing and was patting herself on the chest, four days after receiving the intra muscular injection of Daptacel (dose four) lot number C2253AA in the left thigh on 26Aug05. The pt received in concomitant the IM injection of Prevnar lot number A94451K in the left thigh. Pt''s mom states that her daughter had 3 doses of Tripedia at ages 2, 4 and 6 months. Dates of administration not reported. She showed signs of Autism at 7 months of age. At 12 months they had her hearing checked because she was ignoring her mom and dad. The pt''s hearing was good. Pt received MMR dose one at 12 months of age and experienced crying, fever and listlessness which was never reported. Mom stated they are working with a neurologist to prove autism. No further information was provided by the reporter.


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