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This is VAERS ID 25557

Case Details

VAERS ID: 25557 (history)  
Form: Version 1.0  
Age: 1.3  
Sex: Female  
Location: Indiana  
Vaccinated:1990-07-09
Onset:1990-07-11
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 1990-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 279945 / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 2366R / UNK - / -

Administered by: Private       Purchased by: Private
Symptoms: Apnoea, Convulsion, Laboratory test abnormal, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Acute central respiratory depression (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Generalised convulsive seizures following immunisation (narrow), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: WBC 13.0, RBC 4.37, HgB 10.3, Hct 31.4, MCV 72, MCH 23.6, MCHC 32.8, Platelets 450, Seg 82, lymph 16, stab 2
CDC Split Type:

Write-up: Onset w/ fever, napped, woke w/ jerking -all extremities - & seemed to stop breathing, vomited X1. No sxs 7-10-90. Given APAP q4h on 7-11-90.


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