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This is VAERS ID 25496

Case Details

VAERS ID: 25496 (history)  
Form: Version 1.0  
Age: 1.3  
Sex: Female  
Location: Georgia  
Vaccinated:1990-07-04
Onset:1990-07-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 1990-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0F11081 / 4 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 10205 / UNK LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 275931 / 4 - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Gaze palsy, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Ocular motility disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: TB Tine by Lederle on 4Jul90
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: TEMP 105 F, (axillary), episode where eyes keep moving side to side for approx. 10 min. Pt alert during this. Temp in the office 101.6 F 1 day post vaccination


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