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This is VAERS ID 26102

(NOTE: This result is from the 12/31/2003 version of the VAERS database)

Case Details

VAERS ID: 26102 (history)  
Form: Version .0  
Age: 0.2  
Sex: Male  
Location: Oklahoma  
Vaccinated:1990-08-21
Onset:1990-09-03
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 1990-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 283913 / 2 RL / IM
HIBV: UNK. HAEMOPHILUS B / UNCLASSIFIED M66FB / 0 LL / IM
MMR: MMR II / MSD 12925 / 0 RA / SC
OPV: ORIMUNE / LEDERLE 277942 / 2 - / PO

Administered by: Public       Purchased by: Unknown
Symptoms: AGITATION, CONFUS, GAIT ABNORM, SKIN DISCOLOR, SOMNOLENCE
SMQs:

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 12 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Ceftriaxone 500 mg IV, Augmentin 250 Mgn tid X 1 wk
Current Illness: none WIC recert.
Preexisting Conditions: 10/89 Sizemore, PA no known allergies
Allergies:
Diagnostic Lab Data: CSF & Blood Cultures - Haemophilus Influenza done 7SEP90
CDC Split Type:

Write-up: vomiting, lethargy, restless, disoriented, can''t walk, stiff discoloration of feet & hands


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