| VAERS ID: |
25941 (history) |
| Form: |
Version 1.0 |
| Age: |
1.3 |
| Sex: |
Male |
| Location: |
Pennsylvania |
| Vaccinated: | 1990-02-12 |
| Onset: | 1990-02-18 |
| Days after vaccination: | 6 |
| Submitted: |
1990-09-10 |
| Days after onset: | 203 |
| Entered: |
1990-09-13 |
| Days after submission: | 3 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. |
- / UNK |
- / IM L |
Administered by: Private Purchased by: Private
Symptoms: Agitation,
Convulsion,
Hypokinesia,
Muscle twitching,
Pyrexia,
Somnolence
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (narrow), Dementia (broad), Convulsions (narrow), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Hypotonic-hyporesponsive episode (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? Yes, 5 days
Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: EEG normal; Spinal tap normal
CDC Split Type:
Write-up: Pt vaccinated with MMR 7 day later developed irritability, fever 103AX, decreased alertness with seizure like activity with arm twitching & lethargy. |
