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This is VAERS ID 27096

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

Case Details

VAERS ID: 27096 (history)  
Form: Version .0  
Age: 5.2  
Sex: Female  
Location: Montana  
Vaccinated:1990-11-14
Onset:1990-11-28
   Days after vaccination:14
Submitted: 1990-12-10
   Days after onset:12
Entered: 1991-01-10
   Days after submission:31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 271961 / 0 LA / IM
HIBV: HIBTITER / LEDERLE(PRAXIS) - / 0 - / -
MMR: MMR II / MSD 0217S / 0 RA / IM
OPV: ORIMUNE / LEDERLE 275925 / 0 - / PO

Administered by: Public       Purchased by: Unknown
Symptoms: ASTHENIA, GUILLAIN BARRE SYND
SMQs:

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: had EMG consistant /w Guillain Barre, Had negative spinal tap , CAT scan
CDC Split Type:

Write-up: Guillian Barre Syndrome requiring intubation. Pt is still in hosp as of 10Dec90, Developed weakness on 28Nov90


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=27096


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