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This is VAERS ID 43432

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

Case Details

VAERS ID: 43432 (history)  
Form: Version .0  
Age: 0.2  
Sex: Female  
Location: California  
Vaccinated:1992-01-16
Onset:1992-01-19
   Days after vaccination:3
Submitted: 1992-07-06
   Days after onset:168
Entered: 1992-07-14
   Days after submission:8
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 316976 / 0 LL / IM
HIBV: HIBTITER / LEDERLE(PRAXIS) M175HH / 0 - / IM
IPV: POLIOVAX / CONNAUGHT LTD 60080 / 0 RL / IM

Administered by: Private       Purchased by: Unknown
Symptoms: AGITATION, BONE FRACT SPONTAN, 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, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CXR-fractured rib-pos;
CDC Split Type:

Write-up: pt recvd vax 16JAN92 & was fussy for next 3 days; seen by MD for extreme irritability adm r/o abd process x-ray neg (rub); d/c next day; f/u noted to have crepitus; CXR for fractured rib -pos;


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=43432


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