VAERS ID: 100117

AGE: 1.1| SEX: M|STATE: SD (United States)

Description

mom reports sz on about 2JAN97 & high temp sz on 9JAN97;

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Symptoms

Convulsion, Febrile convulsion

Vaccines

VAX DATE: 12-26-1996| ONSET DATE: | DAYS TO ONSET:
NameDose #TypeManufacturerLotRouteSite
MEASLES + MUMPS + RUBELLA (MMR II) 1 MMR MERCK & CO. INC. 08802 SC LL
DTP + HIB (TETRAMUNE) 4 DTPHIB PFIZER\WYETH 440744 IM LL

RECVDATE:07-10-1997
RPT_DATE:01-21-1997
CAGE_YR:1
CAGE_MO:0.1
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:Y
HOSPDAYS:2
X_STAY:U
DISABLE:U
RECOVD:Y
LAB_DATA:EEG to be done 25JAN97
V_ADMINBY:PUB
OTHER_MEDS:NONE
CUR_ILL:runny nose-afeb
HISTORY:NONE
PRIOR_VAX:NONE~ ()~~~In patient
SPLTTYPE:SD97008
FORM_VERS:
TODAYS_DATE:
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:
V_FUNDBY:PUB

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