VAERS ID: 25048

AGE: 5| SEX: M|STATE: CA (United States)

Description

pt screaming for hours, still crying much 21May90 & 19Jun90. Parents report still not sleeping well at night, pt appears otherwise healthy now

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Symptoms

Screaming, Insomnia

Vaccines

VAX DATE: 05-17-1990| ONSET DATE: 05-17-1990| DAYS TO ONSET: 0
NameDose #TypeManufacturerLotRouteSite
DTP (TRI-IMMUNOL) 3 DTP LEDERLE LABORATORIES 271914 IM

RECVDATE:07-09-1990
RPT_DATE:
CAGE_YR:
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:U
LAB_DATA:CBC 10.1, WBC 76.9 other labs illegible to read
V_ADMINBY:PVT
OTHER_MEDS:Tylenol
CUR_ILL:
HISTORY:general good health
PRIOR_VAX:~ ()~~~In patient
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:
V_FUNDBY:

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