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This is VAERS ID 42459

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

Case Details

VAERS ID: 42459 (history)  
Form: Version .0  
Age: 0.8  
Sex: Male  
Location: Ohio  
Vaccinated:1992-05-20
Onset:1992-05-22
   Days after vaccination:2
Submitted: 1992-05-29
   Days after onset:7
Entered: 1992-06-05
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 316975 / 1 RL / IM
HEP: HEPTAVAX / MSD 0230V / 0 RL / IM
HIBV: HIBTITER / LEDERLE(PRAXIS) M695HK / 1 LL / IM
OPV: ORIMUNE / LEDERLE 64502 / 1 - / PO

Administered by: Private       Purchased by: Unknown
Symptoms: CONVULS, EYES GAZE UPWARD, TWITCH
SMQs:

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: pt exp sz @ 8mos w/1st DTP/HIB/OPV #1 dose;
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: all neg;
CDC Split Type: NONE

Write-up: Pt recvd vax 20MAY92 & on 22MAY had tonic clonic generalized seizure, eyes rolling & twitching; pt now on Phenobarb;


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=42459


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