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This is VAERS ID 59878

(NOTE: This result is from the 9/14/2018 version of the VAERS database)

Case Details

VAERS ID: 59878 (history)  
Form: Version 1.0  
Age: 1.3  
Sex: Female  
Location: Texas  
Vaccinated:1990-10-12
Onset:1990-10-13
   Days after vaccination:1
Submitted: 1994-02-01
   Days after onset:1207
Entered: 1994-02-14
   Days after submission:13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0J11070 / 1 - / IM L
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0895F / UNK RL / SC

Administered by: Public       Purchased by: Public
Symptoms: Mental retardation severity unspecified, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC Split Type: TX9420

Write-up: pt recvd vax & exp fever & was dx as developmentally delayed;


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20180914&IDNUMBER=59878


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