National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 134756

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 134756
VAERS Form:
Age:4.6
Sex:Female
Location:Wisconsin
Vaccinated:2000-01-05
Onset:2000-01-05
Submitted:2000-03-06
Entered:2000-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUSHIELD 1999-2000 / WYETH 4998229 / 1 LA / IM
PPV: PNEUMOVAX 23 / MSD 1483J / - RA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: CONVULS, CONFUS, CREATINE PK INC, COMA, DELIRIUM

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 42     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Albuterol
Current Illness: RSV infection
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data: MRI brain-diffuse abn white matter, LP (2) both nml, Viral culture, Toxicology test on blood-neg, electrolytes-nml, elevated Creatine Kinase-7,000, serum organic acid & amino acid analysis-nml.
CDC 'Split Type':

Write-up: Pt brought to ER w/fever of 106, 3 hrs post/vax. Pt became delirious. By the next AM, pt had a seizure & was transferred to other hosp & admitted. Put on respirator & managed for encephalopathy & cerebral edema. MRI abnormal & pt w/RSV.


Changed on 12/8/2009

VAERS ID: 134756 Before After
VAERS Form:
Age:4.6
Sex:Female
Location:Wisconsin
Vaccinated:2000-01-05
Onset:2000-01-05
Submitted:2000-03-06
Entered:2000-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUSHIELD 1999-2000 INFLUENZA (SEASONAL) (FLUSHIELD 99-00) / WYETH WYETH PHARMACEUTICALS, INC 4998229 / 1 LA / IM
PPV: PNEUMOVAX 23 PNEUMO (PNEUMOVAX) / MSD MERCK & CO. INC. 1483J / - RA / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Blood creatine phosphokinase increased, Coma, Confusional state, Convulsion, Delirium, Dyspnoea, Encephalopathy, Hemiplegia, Infection, Pyrexia, Speech disorder, Brain oedema, CONVULS, CONFUS, CREATINE PK INC, COMA, DELIRIUM

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 42     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Albuterol
Current Illness: RSV infection
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data: MRI brain-diffuse abn white matter, LP (2) both nml, Viral culture, Toxicology test on blood-neg, electrolytes-nml, elevated Creatine Kinase-7,000, serum organic acid & amino acid analysis-nml.
CDC 'Split Type':

Write-up: Pt brought to ER w/fever of 106, 3 hrs post/vax. Pt became delirious. By the next AM, pt had a seizure & was transferred to other hosp & admitted. Put on respirator & managed for encephalopathy & cerebral edema. MRI abnormal & pt w/RSV.


Changed on 8/31/2010

VAERS ID: 134756 Before After
VAERS Form:
Age:4.6
Sex:Female
Location:Wisconsin
Vaccinated:2000-01-05
Onset:2000-01-05
Submitted:2000-03-06
Entered:2000-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUSHIELD 99-00) INFLUENZA (SEASONAL) (FLUSHIELD) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH 4998229 / 1 LA / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 1483J / - RA / IM

Administered by: Other      Purchased by: Other
Symptoms: Blood creatine phosphokinase increased, Coma, Confusional state, Convulsion, Delirium, Dyspnoea, Encephalopathy, Hemiplegia, Infection, Pyrexia, Speech disorder, Brain oedema

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 42     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Albuterol
Current Illness: RSV infection
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data: MRI brain-diffuse abn white matter, LP (2) both nml, Viral culture, Toxicology test on blood-neg, electrolytes-nml, elevated Creatine Kinase-7,000, serum organic acid & amino acid analysis-nml.
CDC 'Split Type':

Write-up: Pt brought to ER w/fever of 106, 3 hrs post/vax. Pt became delirious. By the next AM, pt had a seizure & was transferred to other hosp & admitted. Put on respirator & managed for encephalopathy & cerebral edema. MRI abnormal & pt w/RSV.


Changed on 7/7/2013

VAERS ID: 134756 Before After
VAERS Form:
Age:4.6
Sex:Female
Location:Wisconsin
Vaccinated:2000-01-05
Onset:2000-01-05
Submitted:2000-03-06
Entered:2000-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4998229 / 1 LA / IM
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4998229 / 1 LA / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 1483J / - RA / IM

Administered by: Other      Purchased by: Other
Symptoms: Blood creatine phosphokinase increased, Coma, Confusional state, Convulsion, Delirium, Dyspnoea, Encephalopathy, Hemiplegia, Infection, Pyrexia, Speech disorder, Brain oedema

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 42     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Albuterol
Current Illness: RSV infection
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data: MRI brain-diffuse abn white matter, LP (2) both nml, Viral culture, Toxicology test on blood-neg, electrolytes-nml, elevated Creatine Kinase-7,000, serum organic acid & amino acid analysis-nml.
CDC 'Split Type':

Write-up: Pt brought to ER w/fever of 106, 3 hrs post/vax. Pt became delirious. By the next AM, pt had a seizure & was transferred to other hosp & admitted. Put on respirator & managed for encephalopathy & cerebral edema. MRI abnormal & pt w/RSV.


Changed on 2/14/2017

VAERS ID: 134756 Before After
VAERS Form:
Age:4.6 4.0
Sex:Female
Location:Wisconsin
Vaccinated:2000-01-05
Onset:2000-01-05
Submitted:2000-03-06
Entered:2000-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4998229 / 1 LA / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 1483J / - RA / IM

Administered by: Other      Purchased by: Other
Symptoms: Blood creatine phosphokinase increased, Coma, Confusional state, Convulsion, Delirium, Dyspnoea, Encephalopathy, Hemiplegia, Infection, Pyrexia, Speech disorder, Brain oedema

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 42     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Albuterol
Current Illness: RSV infection
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data: MRI brain-diffuse abn white matter, LP (2) both nml, Viral culture, Toxicology test on blood-neg, electrolytes-nml, elevated Creatine Kinase-7,000, serum organic acid & amino acid analysis-nml.
CDC 'Split Type':

Write-up: Pt brought to ER w/fever of 106, 3 hrs post/vax. Pt became delirious. By the next AM, pt had a seizure & was transferred to other hosp & admitted. Put on respirator & managed for encephalopathy & cerebral edema. MRI abnormal & pt w/RSV.


Changed on 5/14/2017

VAERS ID: 134756 Before After
VAERS Form:
Age:4.0
Sex:Female
Location:Wisconsin
Vaccinated:2000-01-05
Onset:2000-01-05
Submitted:2000-03-06
Entered:2000-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4998229 / 1 LA / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 1483J / - RA / IM

Administered by: Other Private      Purchased by: Other Private
Symptoms: Blood creatine phosphokinase increased, Coma, Confusional state, Convulsion, Delirium, Dyspnoea, Encephalopathy, Hemiplegia, Infection, Pyrexia, Speech disorder, Brain oedema

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 42     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Albuterol
Current Illness: RSV infection
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data: MRI brain-diffuse abn white matter, LP (2) both nml, Viral culture, Toxicology test on blood-neg, electrolytes-nml, elevated Creatine Kinase-7,000, serum organic acid & amino acid analysis-nml.
CDC 'Split Type':

Write-up: Pt brought to ER w/fever of 106, 3 hrs post/vax. Pt became delirious. By the next AM, pt had a seizure & was transferred to other hosp & admitted. Put on respirator & managed for encephalopathy & cerebral edema. MRI abnormal & pt w/RSV. w/RSV.60 day follow-up dated 11/01/00 states the pt is fully recovered, but MRI of brain shows some resigual abnormality.


Changed on 9/14/2017

VAERS ID: 134756 Before After
VAERS Form:(blank) 1
Age:4.0
Sex:Female
Location:Wisconsin
Vaccinated:2000-01-05
Onset:2000-01-05
Submitted:2000-03-06
Entered:2000-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4998229 / 1 2 LA / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 1483J / - UNK RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Blood creatine phosphokinase increased, Coma, Confusional state, Convulsion, Delirium, Dyspnoea, Encephalopathy, Hemiplegia, Infection, Pyrexia, Speech disorder, Brain oedema

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 42     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Albuterol
Current Illness: RSV infection
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data: MRI brain-diffuse abn white matter, LP (2) both nml, Viral culture, Toxicology test on blood-neg, electrolytes-nml, elevated Creatine Kinase-7,000, serum organic acid & amino acid analysis-nml.
CDC 'Split Type':

Write-up: Pt brought to ER w/fever of 106, 3 hrs post/vax. Pt became delirious. By the next AM, pt had a seizure & was transferred to other hosp & admitted. Put on respirator & managed for encephalopathy & cerebral edema. MRI abnormal & pt w/RSV.60 day follow-up dated 11/01/00 states the pt is fully recovered, but MRI of brain shows some resigual abnormality.


Changed on 2/14/2018

VAERS ID: 134756 Before After
VAERS Form:1
Age:4.0
Sex:Female
Location:Wisconsin
Vaccinated:2000-01-05
Onset:2000-01-05
Submitted:2000-03-06
Entered:2000-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4998229 / 2 LA / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 1483J / UNK RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Blood creatine phosphokinase increased, Coma, Confusional state, Convulsion, Delirium, Dyspnoea, Encephalopathy, Hemiplegia, Infection, Pyrexia, Speech disorder, Brain oedema

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 42     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Albuterol
Current Illness: RSV infection
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data: MRI brain-diffuse abn white matter, LP (2) both nml, Viral culture, Toxicology test on blood-neg, electrolytes-nml, elevated Creatine Kinase-7,000, serum organic acid & amino acid analysis-nml.
CDC 'Split Type':

Write-up: Pt brought to ER w/fever of 106, 3 hrs post/vax. Pt became delirious. By the next AM, pt had a seizure & was transferred to other hosp & admitted. Put on respirator & managed for encephalopathy & cerebral edema. MRI abnormal & pt w/RSV.60 day follow-up dated 11/01/00 states the pt is fully recovered, but MRI of brain shows some resigual abnormality.


Changed on 6/14/2018

VAERS ID: 134756 Before After
VAERS Form:1
Age:4.0
Sex:Female
Location:Wisconsin
Vaccinated:2000-01-05
Onset:2000-01-05
Submitted:2000-03-06
Entered:2000-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4998229 / 2 LA / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 1483J / UNK RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Blood creatine phosphokinase increased, Coma, Confusional state, Convulsion, Delirium, Dyspnoea, Encephalopathy, Hemiplegia, Infection, Pyrexia, Speech disorder, Brain oedema

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 42     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Albuterol
Current Illness: RSV infection
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data: MRI brain-diffuse abn white matter, LP (2) both nml, Viral culture, Toxicology test on blood-neg, electrolytes-nml, elevated Creatine Kinase-7,000, serum organic acid & amino acid analysis-nml.
CDC 'Split Type':

Write-up: Pt brought to ER w/fever of 106, 3 hrs post/vax. Pt became delirious. By the next AM, pt had a seizure & was transferred to other hosp & admitted. Put on respirator & managed for encephalopathy & cerebral edema. MRI abnormal & pt w/RSV.60 day follow-up dated 11/01/00 states the pt is fully recovered, but MRI of brain shows some resigual abnormality.


Changed on 8/14/2018

VAERS ID: 134756 Before After
VAERS Form:1
Age:4.0
Sex:Female
Location:Wisconsin
Vaccinated:2000-01-05
Onset:2000-01-05
Submitted:2000-03-06
Entered:2000-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4998229 / 2 LA / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 1483J / UNK RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Blood creatine phosphokinase increased, Coma, Confusional state, Convulsion, Delirium, Dyspnoea, Encephalopathy, Hemiplegia, Infection, Pyrexia, Speech disorder, Brain oedema

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 42     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Albuterol
Current Illness: RSV infection
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data: MRI brain-diffuse abn white matter, LP (2) both nml, Viral culture, Toxicology test on blood-neg, electrolytes-nml, elevated Creatine Kinase-7,000, serum organic acid & amino acid analysis-nml.
CDC 'Split Type':

Write-up: Pt brought to ER w/fever of 106, 3 hrs post/vax. Pt became delirious. By the next AM, pt had a seizure & was transferred to other hosp & admitted. Put on respirator & managed for encephalopathy & cerebral edema. MRI abnormal & pt w/RSV.60 day follow-up dated 11/01/00 states the pt is fully recovered, but MRI of brain shows some resigual abnormality.


Changed on 9/14/2018

VAERS ID: 134756 Before After
VAERS Form:1
Age:4.0
Sex:Female
Location:Wisconsin
Vaccinated:2000-01-05
Onset:2000-01-05
Submitted:2000-03-06
Entered:2000-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4998229 / 2 LA / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 1483J / UNK RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Blood creatine phosphokinase increased, Coma, Confusional state, Convulsion, Delirium, Dyspnoea, Encephalopathy, Hemiplegia, Infection, Pyrexia, Speech disorder, Brain oedema

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 42     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Albuterol
Current Illness: RSV infection
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data: MRI brain-diffuse abn white matter, LP (2) both nml, Viral culture, Toxicology test on blood-neg, electrolytes-nml, elevated Creatine Kinase-7,000, serum organic acid & amino acid analysis-nml.
CDC 'Split Type':

Write-up: Pt brought to ER w/fever of 106, 3 hrs post/vax. Pt became delirious. By the next AM, pt had a seizure & was transferred to other hosp & admitted. Put on respirator & managed for encephalopathy & cerebral edema. MRI abnormal & pt w/RSV.60 day follow-up dated 11/01/00 states the pt is fully recovered, but MRI of brain shows some resigual abnormality.


Changed on 10/14/2018

VAERS ID: 134756 Before After
VAERS Form:1
Age:4.0
Sex:Female
Location:Wisconsin
Vaccinated:2000-01-05
Onset:2000-01-05
Submitted:2000-03-06
Entered:2000-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4998229 / 2 LA / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 1483J / UNK RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Blood creatine phosphokinase increased, Coma, Confusional state, Convulsion, Delirium, Dyspnoea, Encephalopathy, Hemiplegia, Infection, Pyrexia, Speech disorder, Brain oedema

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 42     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Albuterol
Current Illness: RSV infection
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data: MRI brain-diffuse abn white matter, LP (2) both nml, Viral culture, Toxicology test on blood-neg, electrolytes-nml, elevated Creatine Kinase-7,000, serum organic acid & amino acid analysis-nml.
CDC 'Split Type':

Write-up: Pt brought to ER w/fever of 106, 3 hrs post/vax. Pt became delirious. By the next AM, pt had a seizure & was transferred to other hosp & admitted. Put on respirator & managed for encephalopathy & cerebral edema. MRI abnormal & pt w/RSV.60 day follow-up dated 11/01/00 states the pt is fully recovered, but MRI of brain shows some resigual abnormality.


Changed on 12/24/2020

VAERS ID: 134756 Before After
VAERS Form:1
Age:4.0
Sex:Female
Location:Wisconsin
Vaccinated:2000-01-05
Onset:2000-01-05
Submitted:2000-03-06
Entered:2000-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4998229 / 2 LA / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 1483J / UNK RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Blood creatine phosphokinase increased, Coma, Confusional state, Convulsion, Delirium, Dyspnoea, Encephalopathy, Hemiplegia, Infection, Pyrexia, Speech disorder, Brain oedema

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 42     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Albuterol
Current Illness: RSV infection
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data: MRI brain-diffuse abn white matter, LP (2) both nml, Viral culture, Toxicology test on blood-neg, electrolytes-nml, elevated Creatine Kinase-7,000, serum organic acid & amino acid analysis-nml.
CDC 'Split Type':

Write-up: Pt brought to ER w/fever of 106, 3 hrs post/vax. Pt became delirious. By the next AM, pt had a seizure & was transferred to other hosp & admitted. Put on respirator & managed for encephalopathy & cerebral edema. MRI abnormal & pt w/RSV.60 day follow-up dated 11/01/00 states the pt is fully recovered, but MRI of brain shows some resigual abnormality.


Changed on 12/30/2020

VAERS ID: 134756 Before After
VAERS Form:1
Age:4.0
Sex:Female
Location:Wisconsin
Vaccinated:2000-01-05
Onset:2000-01-05
Submitted:2000-03-06
Entered:2000-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4998229 / 2 LA / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 1483J / UNK RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Blood creatine phosphokinase increased, Coma, Confusional state, Convulsion, Delirium, Dyspnoea, Encephalopathy, Hemiplegia, Infection, Pyrexia, Speech disorder, Brain oedema

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 42     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Albuterol
Current Illness: RSV infection
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data: MRI brain-diffuse abn white matter, LP (2) both nml, Viral culture, Toxicology test on blood-neg, electrolytes-nml, elevated Creatine Kinase-7,000, serum organic acid & amino acid analysis-nml.
CDC 'Split Type':

Write-up: Pt brought to ER w/fever of 106, 3 hrs post/vax. Pt became delirious. By the next AM, pt had a seizure & was transferred to other hosp & admitted. Put on respirator & managed for encephalopathy & cerebral edema. MRI abnormal & pt w/RSV.60 day follow-up dated 11/01/00 states the pt is fully recovered, but MRI of brain shows some resigual abnormality.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=134756&WAYBACKHISTORY=ON


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166