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This is VAERS ID 51148

Case Details

VAERS ID: 51148 (history)  
Form: Version 1.0  
Age: 54.0  
Sex: Male  
Location: D.C.  
Vaccinated:1993-02-20
Onset:1993-02-21
   Days after vaccination:1
Submitted: 1993-03-16
   Days after onset:23
Entered: 1993-03-25
   Days after submission:9
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEN: MENINGOCOCCAL (MENOMUNE) / CONNAUGHT LABORATORIES 2K41040 / UNK - / IM A
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME) / PFIZER/WYETH 4928055 / UNK - / SC A
YF: YELLOW FEVER (YF-VAX) / CONNAUGHT LABORATORIES 2H31154 / UNK - / IM A

Administered by: Military       Purchased by: Military
Symptoms: Asthenia, Chills, Dyspnoea, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
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: ~ ()~~~In patient
Other Medications: Pt recvd Immune Globulin by Armour Pharm co lot# F15907; Lopressor
Current Illness:
Preexisting Conditions: pt has hx of hypertrophic cardiomyopathy;
Allergies:
Diagnostic Lab Data:
CDC Split Type: 893075002E

Write-up: Pt devel fever, chills, SOB & weakness, 24 hrs p/vax;


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