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This is VAERS ID 76687

(NOTE: This result is from the 8/14/2018 version of the VAERS database)

Case Details

VAERS ID: 76687 (history)  
Form: Version 1.0  
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 - / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

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), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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: ~ ()~~~In patient
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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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20180814&IDNUMBER=76687


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