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This is VAERS ID 28501

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

Case Details

VAERS ID: 28501 (history)  
Form: Version .0  
Age: 2.6  
Sex: Male  
Location: New York  
Vaccinated:1990-10-29
Onset:1990-11-03
   Days after vaccination:5
Submitted: 1991-02-13
   Days after onset:102
Entered: 1991-03-06
   Days after submission:21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP / CONNAUGHT LABS 0M11148 / 3 LL / IM
HIBV: PROHIBIT / CONNAUGHT LABS 0I11070 / 0 RL / -
MMR: MMR II / MSD 15685 / 0 LA / -
OPV: ORIMUNE / LEDERLE 0620C / 2 - / PO

Administered by: Private       Purchased by: Unknown
Symptoms: CONVULS GRAND MAL, DYSPNEA
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: had c/o headache since fall on 5OCT
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CT & MRI Scans- normal. Spinal Fluid - normal; EEG - abnormal.
CDC Split Type:

Write-up: Presented to ER just a/MN on 3NOV90 w/focal status epilepticus required large dose of anticonvulsants intubation & mechanical ventilation a/sz stopped. Pt continues to require anticonvulsants.


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=28501


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