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This is VAERS ID 26998

(NOTE: This result is from the 8/14/2018 version of the VAERS database)

Case Details

VAERS ID: 26998 (history)  
Form: Version 1.0  
Age: 1.3  
Sex: Female  
Location: North Carolina  
Vaccinated:1990-11-02
Onset:1990-11-04
   Days after vaccination:2
Submitted: 1990-11-06
   Days after onset:2
Entered: 1990-12-14
   Days after submission:38
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 285919 / 4 LL / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0A21092 / 1 LA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0696S / 1 RA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0613K / 3 MO / PO

Administered by: Public       Purchased by: Public
Symptoms: Agitation, Asthma, Bronchiolitis, Pyrexia
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), 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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: NC90005

Write-up: Pt vaccinated with DTP/OPV/MMR/HIB became irritable, crying, wheezing, fever 101, Taken to ER; breathing was stabilized transferred to another hosp dx bronchiolitis not believed to be vaccine related.


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20180814&IDNUMBER=26998


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