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This is VAERS ID 27648

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

Case Details

VAERS ID: 27648 (history)  
Form: Version .0  
Age: 1.3  
Sex: Female  
Location: New York  
Vaccinated:1990-11-05
Onset:1990-11-12
   Days after vaccination:7
Submitted: 1991-01-25
   Days after onset:74
Entered: 1991-02-01
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIBTITER / LEDERLE(PRAXIS) M030FC / 0 LA / SC
MMR: MMR II / MSD 1707S / 0 RA / SC

Administered by: Private       Purchased by: Unknown
Symptoms: APNEA, COMA, CONVULS, FEVER, TREMOR
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? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: WBC 17,400, NOSC CX PIII, TC PIII
CDC Split Type:

Write-up: Temp 105 onset 1 wk after MMR vaccine; Pt had episode of shaking, LOC, ?apnea/vs seizure observed 48 hrs in hosp, Recovered completely.


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=27648


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