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From the 1/14/2022 release of VAERS data:

This is VAERS ID 121253

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Case Details

VAERS ID: 121253 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Male  
Location: Pennsylvania  
Vaccinated:1998-11-18
Onset:1998-11-19
   Days after vaccination:1
Submitted: 1999-04-12
   Days after onset:143
Entered: 1999-04-16
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH - / 1 - / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Cerebral haemorrhage, Cerebral infarction, Cerebrovascular disorder, Convulsion, Encephalitis, Immune system disorder, Lymphocytosis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Convulsions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Noninfectious encephalitis (narrow), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: pt recv hep b vax 19SEP98 & 19OCT98
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Brain MRI/CT w/rapidly progressive infarcts, atrophy & hemorrhage;autopsy showed meningoenchephalitis w/hemophagocytosis suggesting an inflammatory process to unk antigen or familial hemophagocytic lymphohistiocytosis
CDC Split Type:

Write-up: pt adm to hosp 19NOV98 w/new onset sz;dx rapidly progressive necrotizing encephalitis;clinically thought to be most consistent w/mitochondrial cytopathy although studies pending;autopsy showed meningoenchephalitis w/hemophagocytosis


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