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This is VAERS ID 25014

Case Details

VAERS ID: 25014 (history)  
Form: Version 1.0  
Age: 0.4  
Sex: Unknown  
Location: South Carolina  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 1990-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 259965 / 2 - / -

Administered by: Private       Purchased by: Unknown
Symptoms: Agitation, Anorexia
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: 8902804.01

Write-up: 4 month old infant received 2nd immunization & became very irritable, fussy & refused to eat. w/ 1st imminization, infant was fussy for about 3 days.


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