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This is VAERS ID 59212

Case Details

VAERS ID: 59212 (history)  
Form: Version 1.0  
Age: 2.0  
Sex: Male  
Location: Illinois  
Vaccinated:1993-05-20
Onset:1993-05-30
   Days after vaccination:10
Submitted: 1993-11-29
   Days after onset:183
Entered: 1994-01-24
   Days after submission:56
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 352914 / 3 LL / -
HIBV: HIB (HIBTITER) / PFIZER/WYETH M630JK / 3 RL / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1110 / 1 RL / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 346940 / 2 MO / PO

Administered by: Public       Purchased by: Public
Symptoms: Apnoea, Convulsion, Mental retardation severity unspecified, Personality disorder, Sepsis, Somnolence, Thinking abnormal
SMQs:, Agranulocytosis (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Acute central respiratory depression (narrow), Psychosis and psychotic disorders (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Generalised convulsive seizures following immunisation (narrow), Respiratory failure (narrow), Hypoglycaemia (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, 4 days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CSF-no dx; blood tests showed infection; EEG-MRI-szs, syrinx on spine (abnl);
CDC Split Type: IL93134

Write-up: 6PM 1JUN fast breathing, clenched fists locked jaw, eyes rolled, shaking/stiff body then stopped breathing per mom; has had 5 other sz since then; no hx of sz a/; mom says pt has t99-100 during sz;


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