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This is VAERS ID 78939

Case Details

VAERS ID: 78939 (history)  
Form: Version 1.0  
Age: 11.0  
Sex: Female  
Location: Kansas  
Vaccinated:1995-05-12
Onset:1995-05-19
   Days after vaccination:7
Submitted: 1995-11-07
   Days after onset:172
Entered: 1995-11-14
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1052A / 2 LL / -

Administered by: Public       Purchased by: Other
Symptoms: Agitation, Anorexia, Convulsion, Leukocytosis, Pneumonia
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Eosinophilic pneumonia (broad), Generalised convulsive seizures following immunisation (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (narrow)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 1995-05-22
   Days after onset: 3
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt severely disabled @ 6wks w/DTP dose 1~ ()~~~In patient
Other Medications: Depakote, Lamictal
Current Illness: NONE
Preexisting Conditions: severely mentally & physically disabled-uncontrolled sz disorder
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: pneumonia w/inc szs, 19MAY95 restless, poor appetite, 22MAY95 afeb elevated WBC, prolonged szs just prior to code (epileptic status) lasted $g30mins


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