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This is VAERS ID 28434

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

Case Details

VAERS ID: 28434 (history)  
Form: Version .0  
Age: 1.3  
Sex: Female  
Location: Colorado  
Vaccinated:1990-12-17
Onset:1990-12-30
   Days after vaccination:13
Submitted: 1991-01-22
   Days after onset:23
Entered: 1991-03-05
   Days after submission:42
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIBTITER / LEDERLE(PRAXIS) M030FC / 0 - / -
MMR: MMR II / MSD 0896S / 0 - / -

Administered by: Public       Purchased by: Unknown
Symptoms: CELLULITIS, CONJUNCTIVITIS, EYE DIS, INFECT
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, 3 days
   Extended hospital stay? No
Previous Vaccinations: none
Other Medications:
Current Illness: none
Preexisting Conditions: hx of recurring otitis;croup
Allergies:
Diagnostic Lab Data: blood cultures
CDC Split Type: hx of recurring otitis;croup

Write-up: Lt eye swelling /w rapid progression on 31Dec. Taken to ER & subsequently hospitalized /w orbital cellulitis. Blood cultures showed hemophaelis influenzae


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=28434


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