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This is VAERS ID 27521

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

Case Details

VAERS ID: 27521 (history)  
Form: Version .0  
Age: 0.5  
Sex: Female  
Location: California  
Vaccinated:1991-01-15
Onset:1991-01-15
   Days after vaccination:0
Submitted: 1991-01-16
   Days after onset:1
Entered: 1991-01-25
   Days after submission:9
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 295973 / 2 LA / IM
HEP: ENGERIX-B / SMITHKLINE 36560 / 2 RL / IM
HIBV: HIBTITER / LEDERLE(PRAXIS) M025FC / 1 RL / IM
OPV: ORIMUNE / LEDERLE 285951 / 2 - / PO

Administered by: Private       Purchased by: Unknown
Symptoms: EDEMA INJECT SITE, INJECT SITE REACT, RASH
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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Immediate rxn, moderate erythema & local swelling size of small orange, ice applied given Tylenol. Rxn at DPT site, HIB site & Hepatitis B site - same rxn for all, same tmt.


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=27521


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