National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 27726

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

Case Details

VAERS ID: 27726 (history)  
Form: Version .0  
Age: 1.5  
Sex: Female  
Location: Wisconsin  
Vaccinated:1991-01-21
Onset:1991-01-21
   Days after vaccination:0
Submitted: 1991-01-22
   Days after onset:1
Entered: 1991-02-07
   Days after submission:16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 283913 / 0 RL / IM
MMR: MMR II / MSD 1471S / 0 - / SC
OPV: ORIMUNE / LEDERLE 0615D / 0 - / PO

Administered by: Public       Purchased by: Unknown
Symptoms: CONVULS, SOMNOLENCE, STUPOR
SMQs:

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:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: EEG-neg; Electrolytes-normal; Chempand-essentially negative; CBC-sl lympocytosis
CDC Split Type:

Write-up: Pt drinking milk & began choking head tipped back eyes rolled back,sucking noises w/mouth & tongue gurgling sounds from milk from bottle& mucus. Unresponsive,color pink lower extrem cool to touch,barefoot,lasted 2 min.;Responded-sleep-to ER


New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=27726


Copyright © 2019 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166