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This is VAERS ID 27533

(NOTE: This result is from the 9/14/2017 version of the VAERS database)

Case Details

VAERS ID: 27533 (history)  
Form: Version 1.0  
Age: 1.7  
Sex: Unknown  
Location: Pennsylvania  
Vaccinated:1990-07-16
Onset:1990-08-16
   Days after vaccination:31
Submitted: 1991-01-22
   Days after onset:159
Entered: 1991-01-24
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0J11036 / UNK LA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0897F / 1 RA / SC

Administered by: Private       Purchased by: Private
Symptoms: Aplastic anaemia
SMQs:, Agranulocytosis (narrow), Haematopoietic cytopenias affecting more than one type of blood cell (narrow), Haematopoietic erythropenia (narrow), Myelodysplastic syndrome (broad)

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, 7 days
   Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt vaccinated w/MMR/HIB & 4 wks later developed aplastic anemia.


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20170914&IDNUMBER=27533


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