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This is VAERS ID 101589

Case Details

VAERS ID: 101589 (history)  
Form: Version 1.0  
Age: 1.6  
Sex: Female  
Location: Foreign  
Vaccinated:1996-05-02
Onset:1996-05-11
   Days after vaccination:9
Submitted: 1997-08-06
   Days after onset:452
Entered: 1997-08-11
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -
PER: PERTUSSIS (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Sudden infant death syndrome
SMQs:, Neonatal disorders (narrow)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 1996-05-11
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions: no relevant history
Allergies:
Diagnostic Lab Data: autopsy fulfills all criteria for SIDS;
CDC Split Type: WAES97072078

Write-up: pt recv vax 2MAY96 & exp no immed rxn p/vax; 11MAY96 pt died;autopsy protocol states that apart from being too old pt fulfils all criteria for sudden infant death synd (SIDS);reporter felt that COD was not f/t therapy w/MMR;


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