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This is VAERS ID 25930

Case Details

VAERS ID: 25930 (history)  
Form: Version 1.0  
Age: 6.0  
Sex: Female  
Location: Missouri  
Vaccinated:1990-08-21
Onset:1990-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 281944 / UNK RA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1414S / UNK LA / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 281924 / UNK MO / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Coma, Convulsion, Gaze palsy, Tremor
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Ocular motility disorders (narrow), Generalised convulsive seizures following immunisation (narrow), 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:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: SMA -7, Ca, sleep EEG
CDC Split Type:

Write-up: Child received DPT & MMR & OPV at 9:30 am at Co. Health Dept. at 1:00pm child''s eyes rolled back, "shook", became unconscious, suspect seizure. Had similar episode last summer not assoc. /w immunization.


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