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This is VAERS ID 31050

(NOTE: This result is from the 9/14/2017 version of the VAERS database)

Case Details

VAERS ID: 31050 (history)  
Form: Version 1.0  
Age: 1.3  
Sex: Female  
Location: Kansas  
Vaccinated:1991-03-22
Onset:1991-03-31
   Days after vaccination:9
Submitted: 1991-04-04
   Days after onset:4
Entered: 1991-06-06
   Days after submission:62
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0555S / 1 LL / -

Administered by: Public       Purchased by: Other
Symptoms: Face oedema, Pyrexia, Rhinitis, Stupor
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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, 2 days
   Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: Rondec
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CXR
CDC Split Type: KS9115

Write-up: t99-100, congestion, swollen, mattery eyes 2-3 days prior to becoming non-responsive; taken to hosp & given oxygen, suctioned & breathing tx; given antibiotic, IV fluids, & APAP suppositories;


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