This is VAERS ID 57404

(NOTE: This result is from the 2/14/2017 version of the VAERS database)

Case Details

VAERS ID:	57404 (history)
Form:	Version .0
Age:	8.0
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=20170214&IDNUMBER=57404