National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 31362

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

Case Details

VAERS ID: 31362 (history)  
Form: Version .0  
Age: 1.8  
Sex: Female  
Location: Georgia  
Vaccinated:1991-05-08
Onset:1991-05-11
   Days after vaccination:3
Submitted: 1991-06-05
   Days after onset:25
Entered: 1991-06-21
   Days after submission:16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 271965 / 3 RL / IM
HIBV: HIBTITER / LEDERLE(PRAXIS) M560FP / 0 LL / IM
MMR: MMR II / MSD 1343S / 0 RA / SC
OPV: ORIMUNE / LEDERLE 0627L / 2 - / PO

Administered by: Public       Purchased by: Unknown
Symptoms: CYANOSIS, DYSPNEA, FEVER, VOMIT
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, 6 days
   Extended hospital stay? No
Previous Vaccinations: Father states sister had asthma p/#1 DTP;
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Hx of asthma
Allergies:
Diagnostic Lab Data:
CDC Split Type: Hx of asthma

Write-up: 11MAY91 onset couldn''t breathe - hx of asthma taken to ER; 12MAY91 started vomiting, trouble breathing lips cyanotic returned to Hosp admited til 14AUG91, placed on 02 had fever fr 8MAY91-17MAY91 102-103;


New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=31362


Copyright © 2019 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166