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This is VAERS ID 25515

Case Details

VAERS ID: 25515 (history)  
Form: Version 1.0  
Age:   
Sex: Male  
Location: Arizona  
Vaccinated:1990-06-20
Onset:1990-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Private       Purchased by: Unknown
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), 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: ~ ()~~~In patient
Other Medications: Suprax 100 mg qd
Current Illness:
Preexisting Conditions: chronic otitis media on Abx suppression
Allergies:
Diagnostic Lab Data: exam- no source of infection, urine - neg.
CDC Split Type:

Write-up: Temp 105 F, slow to come down with Tylenol & baths. Immunization given in a.m. Rxn in p.m. of same day. Had gotten DPT/OPV/MMR/HIB vaccine that day


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