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This is VAERS ID 67562

Case Details

VAERS ID: 67562 (history)  
Form: Version 1.0  
Age: 1.25  
Sex: Female  
Location: Iowa  
Vaccinated:1994-09-30
Onset:1994-10-02
   Days after vaccination:2
Submitted: 1994-10-18
   Days after onset:16
Entered: 1994-10-24
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0830A / 1 LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Cerebral haemorrhage, Coagulopathy, Convulsion, Haemorrhage, Vomiting
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Systemic lupus erythematosus (broad), Haemorrhagic central nervous system vascular conditions (narrow), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1994-10-06
   Days after onset: 4
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none;
Current Illness: none;
Preexisting Conditions: none;
Allergies:
Diagnostic Lab Data: nl platelets ct; no purpura;
CDC Split Type:

Write-up: pt recvd vax at checkup; onset of vomiting 2 days after vax; v sporadic, then freq til onset of focal sz 2 days later; ct scan showed cerebral hemorrhage; analysis showed DIC-like picture; cont cns bleeding, eventual death; no post mortem;


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