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This is VAERS ID 27394

(NOTE: This result is from the 8/31/2010 version of the VAERS database)

Case Details

VAERS ID: 27394 (history)  
Form: Version .0  
Age: 1.6  
Sex: Female  
Location: Missouri  
Vaccinated:1990-11-29
Onset:1990-12-04
   Days after vaccination:5
Submitted: 1990-12-18
   Days after onset:14
Entered: 1991-01-14
   Days after submission:27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DT: DT ADSORBED (NO BRAND NAME) / PFIZER/WYETH 4908019 / - LA / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 01920168 / 0 RA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1414S / 0 RA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES 281925 / 2 - / PO

Administered by: Public       Purchased by: Public
Symptoms: Febrile convulsion, Otitis media
SMQs:, Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (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 pt; 7mo; DTP;3
Other Medications:
Current Illness:
Preexisting Conditions: Febrile seizure after 3 DTP on 6NOV89.
Allergies:
Diagnostic Lab Data:
CDC Split Type: MO903

Write-up: 5 days after vaccination, dev temp 103+ for 48 hrs - 2 seizures related to temp elevation. Treated for otitis media at Hospital 2 days later


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20100831&IDNUMBER=27394


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