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This is VAERS ID 25971

Case Details

VAERS ID: 25971 (history)  
Form: Version 1.0  
Age: 5.0  
Sex: Female  
Location: New Jersey  
Vaccinated:1987-01-24
Onset:1987-01-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES - / UNK - / IM

Administered by: Private       Purchased by: Unknown
Symptoms: Deafness, Injection site reaction, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hearing impairment (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Referral to Audiologist for Brainstem Response Audiometry.
CDC Split Type:

Write-up: Pt vaccinated with DTP developed high fevers resulting in progressive hearing impairment. Had frequent assoc rx w/local induration & swelling of injection site. elevated temp noted w/progressive deterioration of hearing abilities.


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