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This is VAERS ID 27548

(NOTE: This result is from the 2/14/2018 version of the VAERS database)

Case Details

VAERS ID: 27548 (history)  
Form: Version 1.0  
Age: 1.4  
Sex: Male  
Location: Virginia  
Vaccinated:1990-11-15
Onset:1990-11-25
   Days after vaccination:10
Submitted: 1991-01-08
   Days after onset:44
Entered: 1991-01-25
   Days after submission:17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 285965 / 4 LL / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0A21133 / 1 RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1487S / 1 LA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 287939 / 3 MO / PO

Administered by: Public       Purchased by: Public
Symptoms: Hypotonia, Pyrexia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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, 3 days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: VA91004

Write-up: Pt vaccinated w/DTP/OPV/MMR/HIB 10 days /p developed rash, fever 106.3, limp taken to ER hospitalized 3 days.


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20180214&IDNUMBER=27548


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