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This is VAERS ID 31009

Case Details

VAERS ID: 31009 (history)  
Form: Version 1.0  
Age: 1.5  
Sex: Male  
Location: South Dakota  
Vaccinated:1990-02-13
Onset:1990-02-17
   Days after vaccination:4
Submitted: 1991-05-18
   Days after onset:454
Entered: 1991-06-05
   Days after submission:18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 241920 / 4 - / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH - / 1 - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 247945 / 3 MO / PO

Administered by: Private       Purchased by: Unknown
Symptoms: Autism, Pyrexia, Somnolence, Speech disorder
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CXR- normal; Strep test - negative; Blood bacteria culture - negative;
CDC Split Type:

Write-up: 4days post vax devl running fever; to ER t104 & very lathargic; several tests for various things & couldn''t find anything wrong; given antibiotics as precaution; then lost speech & was dx w/autism in DEC90;


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