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This is VAERS ID 86243

Case Details

VAERS ID: 86243 (history)  
Form: Version 1.0  
Age: 1.3  
Sex: Male  
Location: Minnesota  
Vaccinated:1994-01-26
Onset:1994-02-05
   Days after vaccination:10
Submitted: 1996-05-07
   Days after onset:821
Entered: 1996-05-21
   Days after submission:14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 3H41035 / 4 RL / -
HIBV: HIB (HIBTITER) / PFIZER/WYETH M560KF / 4 RL / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1391W / 1 LL / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 697M2 / 3 MO / PO

Administered by: Public       Purchased by: Other
Symptoms: Agitation, Aphasia, Autism, Convulsion, Gaze palsy, Personality disorder, Pyrexia, Speech disorder
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Ocular motility disorders (narrow), Generalised convulsive seizures following immunisation (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: gantrisin
Current Illness: ear infect
Preexisting Conditions: NONE-had only 3-4 words
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: pt was fussy & w/fever noc a/& all day that noc about 10PM;pt became very hot & given APAP 5min later;911 called took pt to hosp dx autism;behavior changed, (sz disorder), loss eye contact


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