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This is VAERS ID 37479

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

Case Details

VAERS ID: 37479 (history)  
Form: Version .0  
Age: 1.3  
Sex: Female  
Location: Michigan  
Vaccinated:1991-08-22
Onset:1991-08-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1992-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II / MSD 0977T / 0 - / IM

Administered by: Other       Purchased by: Unknown
Symptoms: CONVULS, CSF ABNORM, FEVER, LAB TEST ABNORM, RASH
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, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 25AUG91 WBC Count-7100; Segemented neutrophils-21; BANDS-53; Serum glucose-75; Protein-17; Serum Magnesium-2.4; Serum calcium-9.1; LP-3WBC/HPF;
CDC Split Type:

Write-up: pt recvd MMR vax on 22AUG91 & 36 hrs following vax pt devel a rash & fever; also vomited once; 25AUG91 presented to ER w/tonoclonic seizure; t104.4 ax & pt was hospitalized;


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=37479


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