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This is VAERS ID 57404

(NOTE: This result is from the 5/14/2017 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: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: hx of clef lip repaired (2 mos old) no known allergies;
Allergies:
Diagnostic Lab Data: MRI (Brian, oribts, optic nerve 7 chasm);
CDC Split Type:

Write-up: pt recvd vax 1OCT93 & on 16OCT93 c/o sl h/a; 18OCT93 had sudden lost of vision; seen by MD 20OCT93; hospitalized on 23OCT93 for optic neuritis;


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20170514&IDNUMBER=57404


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