| VAERS ID: |
25817 (history) |
| Form: |
Version .0 |
| Age: |
2.0 |
| Sex: |
Female |
| Location: |
Maryland |
| Vaccinated: | 1990-06-22 |
| Onset: | 1990-06-30 |
| Days after vaccination: | 8 |
| Submitted: |
0000-00-00 |
| Entered: |
1990-08-29 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES |
265938 / 3 |
- / - |
| MEA: MEASLES (NO BRAND NAME) / MERCK & CO. INC. |
- / - |
- / - |
| OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH |
- / - |
- / PO |
Administered by: Private Purchased by: Unknown
Symptoms: Asthenia,
Convulsion,
Pyrexia,
Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (narrow), 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? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: No hx of seizures in siblings/parents. 1 cousin had convulsions /w high fever.
Allergies:
Diagnostic Lab Data:
CDC Split Type: 9001348.01
Write-up: Approx. 8 days /p DTP/OPV/MMR immun., child experienced a fever 101T, rash on face & chest, seizure (1 episode) & fatigue for 24 hrs. |
