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This is VAERS ID 25696

Case Details

VAERS ID: 25696 (history)  
Form: Version 1.0  
Age: 1.8  
Sex: Female  
Location: Illinois  
Vaccinated:1990-05-14
Onset:1990-05-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 1990-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES OB11061 / UNK - / IM L
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0890S / UNK - / IM L
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH - / UNK MO / PO

Administered by: Private       Purchased by: Unknown
Symptoms: Injection site pain, Injection site reaction, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (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: Ceclor
Current Illness: Ear infection took Ceclor 5/7 -5/14
Preexisting Conditions: Infectious Mono in January 1990
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt vaccinated with DTP/MMR/OPV and developed a fever of 104.2; Temp decreased with tylenol and ice pack; Pain and swelling of leg site


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