VAERS ID: 25002

AGE: 82| SEX: M|STATE: FR (Unknown)

Description

23 hrs post vaccination, developed seizures followed by rigor. Vaccine was given as a prophylaxis.

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Symptoms

Chills, Convulsion

Vaccines

VAX DATE: 11-20-1989| ONSET DATE: 11-20-1989| DAYS TO ONSET: 0
NameDose #TypeManufacturerLotRouteSite
PNEUMO (PNEUMOVAX) 0 PPV MERCK & CO. INC. M0870 IM Unknown

RECVDATE:07-02-1990
RPT_DATE:
CAGE_YR:
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:Y
RECOVD:U
LAB_DATA:
V_ADMINBY:
OTHER_MEDS:Thioridazine, Triazolam,
CUR_ILL:
HISTORY:Senile dementia, Diabetes mellitus, seizures
PRIOR_VAX:~ ()~~~In patient
SPLTTYPE:WAES90040535
FORM_VERS:
TODAYS_DATE:
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:
V_FUNDBY:

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