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This is VAERS ID 25922

(NOTE: This result is from the 12/8/2009 version of the VAERS database)

Case Details

VAERS ID: 25922 (history)  
Form: Version .0  
Age: 1.3  
Sex: Male  
Location: Ohio  
Vaccinated:1990-08-14
Onset:1990-08-24
   Days after vaccination:10
Submitted: 1990-09-08
   Days after onset:15
Entered: 1990-09-14
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / LEDERLE PRAXSIS M205EP / - A / SC
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1494S / - A / SC

Administered by: Private       Purchased by: Private
Symptoms: Convulsion, Pallor, Pyrexia, Rash, Rash maculo-papular, Stupor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (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? Yes, 9 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Hearing loss - Rx PET - Chronic ear infection; premature 3 wks early, developmental delay, febrile seizure MAR 90.
Allergies:
Diagnostic Lab Data: EEG 21AUG showed seizure activity w/slowing background - CT & MRI scan normal - Metabolic tests done w/elevated pyruvate & _____ still in progress. Hx of prior developemental delay prior to vaccine.
CDC Split Type:

Write-up: Pt vaccinated with MMR/HIB developed fever X 24hrs w/mild erythema rash upper trunk - Macular papular on 27AUG90; Reevaluated- fever, fading of rash. Short periods of starring, face color changed & dazed state seizure were short. See WORM.


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20091208&IDNUMBER=25922


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