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This is VAERS ID 57404

(NOTE: This result is from the 12/8/2009 version of the VAERS database)

Case Details

VAERS ID: 57404 (history)  
Form: Version .0  
Age: 8.2  
Sex: Female  
Location: Illinois  
Vaccinated:1993-10-01
Onset:1993-10-18
   Days after vaccination:17
Submitted: 1993-11-09
   Days after onset:22
Entered: 1993-11-15
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEA: MEASLES (ATTENUVAX) / MERCK & CO. INC. 1117W / 2 LA / SC

Administered by: Private       Purchased by: Public
Symptoms: Blindness, Headache, Optic neuritis
SMQs:, Glaucoma (broad), Optic nerve disorders (narrow), Demyelination (narrow), Retinal disorders (broad), Ocular infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: hx cleft lip repaired (2o old) NKA;
Allergies:
Diagnostic Lab Data: MRI (Brain, orbits, optical nerve & ?);
CDC Split Type: IL93122

Write-up: pt recvd vax 1OCT93 & c/o h/a; 18NOV loss of vision; seen by MD 20OCT03; hospitalized 23OCT93 for optic neuritis;


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20091208&IDNUMBER=57404


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