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This is VAERS ID 83713

Case Details

VAERS ID: 83713 (history)  
Form: Version 1.0  
Age: 1.3  
Sex: Female  
Location: Colorado  
Vaccinated:1995-04-25
Onset:1995-05-05
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 1996-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 4J51067 / 1 RL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M520LA / 4 LA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1744W / 1 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0707B / 4 MO / PO

Administered by: Public       Purchased by: Public
Symptoms: Apnoea, Blindness, Bradycardia, Convulsion, Encephalitis, Hypoxia, Mental retardation severity unspecified, Myelitis
SMQs:, Asthma/bronchospasm (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Noninfectious encephalitis (narrow), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Optic nerve disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Generalised convulsive seizures following immunisation (narrow), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? Yes
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CT-MRI scan-non specific viral related encephalitis, compounded by hypoxic ischemia-disseminated encephalomyelitis
CDC Split Type: CO96010

Write-up: hypoxia,bradycardia,cyanosis,gen tonic clonic sz,petechiae over head & neck;transferred to hosp was intubated,end result of severe developmental delay,cortical blindness & cont sz activity


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