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This is VAERS ID 25764

Case Details

VAERS ID: 25764 (history)  
Form: Version 1.0  
Age: 0.3  
Sex: Male  
Location: Nevada  
Vaccinated:1983-01-25
Onset:1983-01-26
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 1990-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Convulsion, Dementia
SMQs:, Systemic lupus erythematosus (broad), Dementia (narrow), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: 9000216.01

Write-up: plaintiffs allege that as a result of immunization a 4 mo of age in 1983 (no reference is made to any prior immunization), infant suffered seizures the following day and suffered permanent brain damage.


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