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This is VAERS ID 29507

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

Case Details

VAERS ID: 29507 (history)  
Form: Version .0  
Age: 1.7  
Sex: Male  
Location: Oregon  
Vaccinated:1991-03-12
Onset:1991-03-13
   Days after vaccination:1
Submitted: 1991-03-20
   Days after onset:7
Entered: 1991-04-05
   Days after submission:16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 297908 / 3 - / IM
HIBV: HIBTITER / LEDERLE(PRAXIS) M636FN / 0 - / IM
MMR: MMR II / MSD 2258F / 0 - / IM
OPV: ORIMUNE / LEDERLE 0626F / 2 - / PO

Administered by: Private       Purchased by: Unknown
Symptoms: CONVULS, FEVER
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type: NONE

Write-up: Admitted to hosp w/in 24 hrs of receiving immun w/temp 104 & sz;


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=29507


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