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This is VAERS ID 152834

Case Details

VAERS ID: 152834 (history)  
Form: Version 1.0  
Age: 0.4  
Sex: Male  
Location: Wisconsin  
Vaccinated:1994-05-12
Onset:1994-06-09
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2000-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 3B51129 / 2 - / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1790W / 2 - / IM
HIBV: HIB (ACTHIB) / CONNAUGHT LABORATORIES 3B51129 / 2 - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0699B / 2 MO / PO

Administered by: Public       Purchased by: Public
Symptoms: Cataract, Convulsion, Dyskinesia, Electroencephalogram abnormal, Encephalopathy, Growth retardation, Mental retardation severity unspecified, Vision abnormal neonatal
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Dyskinesia (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Glaucoma (broad), Lens disorders (narrow), Neonatal disorders (narrow), Generalised convulsive seizures following immunisation (narrow), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2000-05-02
   Days after onset: 2154
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ?~Hep B (no brand name)~1~0.00~In Patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: hx of premature birth (37 weeks), low birth weight, descended testicles, asthma (dx at 2 1/2 yrs) pneumonia, sinus infections and bronchitis
Allergies:
Diagnostic Lab Data: Battery of tests, 2 MRI''s, 2 CT scans, 3 EEG''s and all wnl. He had 17 blood draws to check for any metabolic abnormalties, had 1 VER(visually evoked response) during 1 of his EEG''s. His growth hormone level was nml, blood sugar level was nml.
CDC Split Type:

Write-up: The pt was given his first dose of Hep B vaccine at 2 days old. He was a premature child born at 37 weeks and a low birth weight of 4 lbs. 15 oz. The parents state almost "immediately" we could tell that he had vision problems and after a few months he had developmental delays. At less than 3 months old, the pt was given DPT, Polio and Hib. Within about 6 weeks, he developed small "jerks". The MD''s office assured her it was probably nothing. Later these were diagnosed as myoclonic seizures. At 4 months he was unable to hold his head up, roll from tummy to back, push up on arms. At 5 months he received his second doses of the vaccines. Within 4 weeks, he started to have simple partial seizures along with the myoclonic seizures. A neurologist made the diagnoses and prescribed Phenobarbital. Several tests were ordered. At this time the childs growth slowed down as did his brain growth. He was diagnosed as microcep developmentally delayed epileptic and having static encephalopathy (later this was changed to unknown encephalopathy). An ophthalmologist states that the child eyes had developed correctly, but at 19 months the child had cataracts in both eyes and had surgery to remove them. The pertussis part of the vax was discontinued. The MD wanted the child to have a sleep apnea test scheduled for the night of 5/2/00. The child unexpectedly passed away that morning. Autopsy states cause of death acute seizure activity due to chronic seizure disorder.


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