National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 26957

(NOTE: This result is from the 2/14/2018 version of the VAERS database)

Case Details

VAERS ID: 26957 (history)  
Form: Version 1.0  
Age: 1.4  
Sex: Male  
Location: Washington  
Vaccinated:1990-11-10
Onset:1990-11-19
   Days after vaccination:9
Submitted: 1990-12-01
   Days after onset:12
Entered: 1990-12-11
   Days after submission:10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 07415 / 1 - / IM A
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1492S / 1 - / SC A

Administered by: Private       Purchased by: Public
Symptoms: Convulsion, Cyanosis, Gaze palsy, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Acute central respiratory depression (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Ocular motility disorders (narrow), 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? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: WA90493

Write-up: Pt vaccinated with MMR/HIB developed temp $g104 & tonic seizure, w/eyes deviated to left & mild cyanosis - seizure duration less than 2 min - postictal 15-20min. initial eval by MEDICS at childs home. Seen in office within 1 hr of incident.


New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20180214&IDNUMBER=26957


Copyright © 2020 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166