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This is VAERS ID 61839

Case Details

VAERS ID: 61839 (history)  
Form: Version 1.0  
Age: 1.6  
Sex: Male  
Location: Pennsylvania  
Vaccinated:1993-07-28
Onset:1993-08-06
   Days after vaccination:9
Submitted: 1994-01-31
   Days after onset:178
Entered: 1994-04-18
   Days after submission:76
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 3H41043 / 3 LL / -
HIBV: HIB (HIBTITER) / PFIZER/WYETH M020JE / 3 RL / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1052V / 1 RL / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 338920 / 3 MO / PO

Administered by: Public       Purchased by: Public
Symptoms: Apnoea, Convulsion, Pyrexia, Rash maculo-papular
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Acute central respiratory depression (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (narrow), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations: NA~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: meconium blackagl at birth
Allergies:
Diagnostic Lab Data: spinal tap & blood-now growth WBc 10.7;
CDC Split Type: PA93188

Write-up: 6AUG93 pt stopped breathing mouth to mouth given t104.7, sz; CSF & blood OK; 10AUG94 fine erythematous generalized rash dx rosella;


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