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This is VAERS ID 42459

(NOTE: This result is from the 8/31/2010 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: 1992-06-04
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 316975 / 1 RL / IM
HEP: HEP B (FOREIGN) / MERCK & CO. INC. 0230V / 0 RL / IM
HIBV: HIB (HIBTITER) / LEDERLE PRAXSIS M695HK / 1 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES 64502 / 1 - / PO

Administered by: Private       Purchased by: Public
Symptoms: Convulsion, Gaze palsy, Muscle twitching
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Dyskinesia (broad), Dystonia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Ocular motility disorders (narrow)

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:

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=20100831&IDNUMBER=42459


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