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This is VAERS ID 28417

(NOTE: This result is from the 9/14/2018 version of the VAERS database)

Case Details

VAERS ID: 28417 (history)  
Form: Version 1.0  
Age: 1.3  
Sex: Female  
Location: Georgia  
Vaccinated:1991-01-28
Onset:1991-02-03
   Days after vaccination:6
Submitted: 1991-02-19
   Days after onset:16
Entered: 1991-02-25
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER 0C21132 / 1 - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0560S / 1 - / -

Administered by: Private       Purchased by: Unknown
Symptoms: Erythema multiforme, Lacrimal disorder, Petechiae, Purpura, Pyrexia, Rash maculo-papular, Thrombocytopenia, Thrombocytopenic purpura
SMQs:, Severe cutaneous adverse reactions (narrow), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Lacrimal disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow)

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, 4 days
   Extended hospital stay? No
Previous Vaccinations: none~ ()~~~In patient
Other Medications:
Current Illness: otitis media(?)
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: platelet count low 55,000
CDC Split Type:

Write-up: Petechiae-$gpurpura, DX: Idiopathic thrombocytopenic purpura or erthema multiforme, had T of 101-102, runny eyes, measles type rash starting 1FEb con''t into above symptoms 2Feb /w purpura on 3Feb.


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20180914&IDNUMBER=28417


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