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This is VAERS ID 28501

(NOTE: This result is from the 10/14/2018 version of the VAERS database)

Case Details

VAERS ID: 28501 (history)  
Form: Version 1.0  
Age: 2.0  
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: 1991-02-28
   Days after submission:15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0M11148 / 4 LL / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0I11070 / 1 RL / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 15685 / 1 LA / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0620C / 3 MO / PO

Administered by: Private       Purchased by: Private
Symptoms: Dyspnoea, Grand mal convulsion
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

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: ~ ()~~~In patient
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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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20181014&IDNUMBER=28501


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