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This is VAERS ID 134580

Case Details

VAERS ID: 134580 (history)  
Form: Version 1.0  
Age: 1.0  
Sex: Female  
Location: Foreign  
Vaccinated:1999-12-08
Onset:1999-12-17
   Days after vaccination:9
Submitted: 2000-03-01
   Days after onset:75
Entered: 2000-03-07
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / UNK - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / SC
MNC: MENINGOCOCCAL (MENINGITEC) / PFIZER/WYETH - / UNK - / SC

Administered by: Unknown       Purchased by: Unknown
Symptoms: CSF test abnormal, Convulsion, Hernia, Pneumonia
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Generalised convulsive seizures following immunisation (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1999-12-18
   Days after onset: 1
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Cerebrospinal fluid-protein rasied (1.2g/l)
CDC Split Type: 20000052892

Write-up: 9 days post vax, pt exp convulsions. Overnight neurological status worsened, pt died early 11/18. Cause of death: convulsion NOS. Post-mortem: bronchopneumonia, tonsillar herniation. Final brain post-mortem awaited. No further info avail.


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