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This is VAERS ID 28355

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

Case Details

VAERS ID: 28355 (history)  
Form: Version .0  
Age: 1.4  
Sex: Male  
Location: Florida  
   Days after vaccination:8
Submitted: 1991-02-15
   Days after onset:17
Entered: 1991-02-26
   Days after submission:11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II / MSD 22345 / 0 - / SC

Administered by: Other       Purchased by: Unknown

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, 1 days
   Extended hospital stay? No
Previous Vaccinations: unknown
Other Medications: none
Current Illness: none
Preexisting Conditions: unknown
Diagnostic Lab Data: Unknown-in patient record not available to me.
CDC Split Type: unknown

Write-up: pt had fever to 106.1 & seizure. May have had lumbar puncture.

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