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This is VAERS ID 27169

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

Case Details

VAERS ID: 27169 (history)  
Form: Version .0  
Age: 2.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:1990-12-10
Onset:1990-12-11
   Days after vaccination:1
Submitted: 1990-12-14
   Days after onset:3
Entered: 1991-01-02
   Days after submission:19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIBTITER / LEDERLE(PRAXIS) M025FC / 0 - / IM
MMR: MMR II / MSD 1879S / 0 - / IM

Administered by: Public       Purchased by: Unknown
Symptoms: CONVULS, CSF ABNORM, FEVER, MENINGITIS
SMQs:

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, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Ceclor
Current Illness: Mild serious otitis
Preexisting Conditions: partially resolved otitis media
Allergies:
Diagnostic Lab Data: CSF Culture positive - H. Influenza
CDC Split Type:

Write-up: Pt vaccinated with MMR/HIB developed fever, possible convulsion, bacterial meningitis.


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=27169


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