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This is VAERS ID 27169

(NOTE: This result is from the 5/14/2017 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: 1990-12-26
   Days after submission:12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH M025FC / 0 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1879S / 0 - / IM

Administered by: Public       Purchased by: Public
Symptoms: CSF test abnormal, Convulsion, Meningitis, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), 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? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
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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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20170514&IDNUMBER=27169


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