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This is VAERS ID 25921

Case Details

VAERS ID: 25921 (history)  
Form: Version 1.0  
Age: 1.4  
Sex: Male  
Location: Ohio  
Vaccinated:1990-09-06
Onset:1990-09-12
   Days after vaccination:6
Submitted: 1990-09-12
   Days after onset:0
Entered: 1990-09-14
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0J11070 / UNK - / IM A
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 15715 / UNK - / IM L

Administered by: Private       Purchased by: Unknown
Symptoms: Convulsion, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (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), Hypoglycaemia (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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Negative LP; Negative Bloodculture
CDC Split Type:

Write-up: Pt vaccinated with MMR/PROHIBIT developed febrile seizure, temp to 104.5, sen at Childrens Hosp Cinci.


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