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This is VAERS ID 26913

Case Details

VAERS ID: 26913 (history)  
Form: Version 1.0  
Age: 2.0  
Sex: Male  
Location: Alabama  
Vaccinated:1990-11-26
Onset:1990-11-26
   Days after vaccination:0
Submitted: 1990-11-28
   Days after onset:2
Entered: 1990-12-07
   Days after submission:9
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 281947 / 3 RL / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1879S / 1 LA / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 283938 / 3 MO / PO

Administered by: Public       Purchased by: Other
Symptoms: Diarrhoea, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: PPD vaccine by Connaught Lot# 231912
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: AL900003

Write-up: Pt vaccinated with DTP/OPV/MMR began vomiting & diarrhea around 830PM. Temp to 104. Mom call ER & MD, but did not take child to either.


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