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This is VAERS ID 76687

(NOTE: This result is from the 12/8/2009 version of the VAERS database)

Case Details

VAERS ID: 76687 (history)  
Form: Version .0  
Age: 1.4  
Sex: Male  
Location: Minnesota  
Vaccinated:1991-07-24
Onset:1991-08-01
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 1994-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Private       Purchased by: Unknown
Symptoms: Pharyngitis, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1993-08-03
   Days after onset: 733
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: prematurity ( 27 wks gestation,1220 grams birth wt); hypertonia (cerebral palsy); devel delay; none
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: fever, rash , red throat;


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20091208&IDNUMBER=76687


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