National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 7/16/2021 release of VAERS data:

This is VAERS ID 175831



Case Details

VAERS ID: 175831 (history)  
Form: Version 1.0  
Age: 1.25  
Sex: Female  
Location: Minnesota  
Vaccinated:1995-09-25
Onset:1995-09-25
   Days after vaccination:0
Submitted: 2001-09-13
   Days after onset:2180
Entered: 2001-10-01
   Days after submission:18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES - / 4 RL / IM
HIBV: HIB (ACTHIB) / CONNAUGHT LABORATORIES 5E61006 / 4 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0623B / 1 LL / SC
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0430B / 1 LL / SC

Administered by: Private       Purchased by: Private
Symptoms: Aphasia, Diarrhoea, Eye disorder, Hearing impaired
SMQs:, Dementia (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Corneal disorders (broad), Retinal disorders (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hearing impairment (narrow), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: diarrhea, rash~Measles + Mumps + Rubella (no brand name)~2~5.00~In Patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: The pt developed permanent chronic diarrhea, arersion to eye contact, change in hearing and stopped speaking. Diarrhea and loss of speech were immediate others were gradual onset approximately 1 month.


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=175831


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