| VAERS ID: |
28334 (history) |
| Form: |
Version .0 |
| Age: |
1.4 |
| Sex: |
Male |
| Location: |
Missouri |
| Vaccinated: | 1991-01-18 |
| Onset: | 1991-01-24 |
| Days after vaccination: | 6 |
| Submitted: |
1991-02-05 |
| Days after onset: | 12 |
| Entered: |
1991-02-15 |
| Days after submission: | 10 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES |
285920 / 3 |
LL / IM |
| MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. |
1481S / 0 |
RL / SC |
| OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH |
287951 / 2 |
- / PO |
Administered by: Public Purchased by: Public
Symptoms: Anaemia,
Bone marrow depression,
Convulsion,
Infection,
Pyrexia
SMQs:, Agranulocytosis (narrow), Haematopoietic cytopenias affecting more than one type of blood cell (narrow), Haematopoietic erythropenia (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Myelodysplastic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Lab results. U of mo hosital, MD feels child had virus infect 2+ mos ago which caused marrow shutdown
CDC Split Type: MO918
Write-up: 7 days p/vax, T up to 102 relieved by Tylenol 25JAN91, sz 26JAN91 seen in ER. Extremely low red count, seen by MD 28JAN91. Red count low-bone marrow shutdown. Result viral infect 2-3 mos ago. |
