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This is VAERS ID 61563

Case Details

VAERS ID: 61563 (history)  
Form: Version 1.0  
Age: 1.0  
Sex: Male  
Location: Illinois  
   Days after vaccination:80
Submitted: 0000-00-00
Entered: 1994-02-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Private       Purchased by: Other
Symptoms: Cerebrovascular disorder, Convulsion, Electroencephalogram abnormal, Encephalitis, Hemiplegia, Infection, Mental retardation severity unspecified, Personality disorder
SMQs:, Systemic lupus erythematosus (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Convulsions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Noninfectious encephalitis (narrow), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Generalised convulsive seizures following immunisation (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: Failure to thrive, poor eating habits, gastroenteritis, milk intolerance, hx of febrile sz;
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES93021096

Write-up: pt recvd vax 25AUG72 & devel convuls & was hospitalized & dx as having viral encephalitis; pt subsequently discharged from hosp; no further details were provided;

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