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This is VAERS ID 28906

Case Details

VAERS ID: 28906 (history)  
Form: Version 1.0  
Age: 15.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:1989-12-08
Onset:1989-12-27
   Days after vaccination:19
Submitted: 1991-02-27
   Days after onset:427
Entered: 1991-03-08
   Days after submission:9
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1471P / 1 LA / SC

Administered by: Public       Purchased by: Public
Symptoms: Headache
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1989-12-27
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: Finlepsen (Carbamazepine)
Current Illness: NONE
Preexisting Conditions: Epilepsy listed in autopsy as basic cause of death.
Allergies:
Diagnostic Lab Data: pt did not seek medical attention. No tests performed p/vax was administered.
CDC Split Type:

Write-up: Five days p/MMR vax was administered, pt experienced recurring headaches which continued until her death.


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