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This is VAERS ID 167376

Case Details

VAERS ID: 167376 (history)  
Form: Version 1.0  
Age: 1.25  
Sex: Female  
Location: Virginia  
Vaccinated:2001-02-20
Onset:2001-02-23
   Days after vaccination:3
Submitted: 2001-03-15
   Days after onset:20
Entered: 2001-03-20
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1308K / 1 - / SC
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH 472355 / 2 - / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1466K / 1 - / SC

Administered by: Unknown       Purchased by: Unknown
Symptoms: Bronchitis acute, Cardio-respiratory arrest, Contusion, Nasal congestion, Pulmonary oedema, Wheezing
SMQs:, Torsade de pointes/QT prolongation (broad), Cardiac failure (narrow), Anaphylactic reaction (narrow), Angioedema (broad), Asthma/bronchospasm (broad), Haemorrhage terms (excl laboratory terms) (narrow), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (broad), Accidents and injuries (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2001-02-23
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Albuterol, Zithromax.
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt was seen for a well 15 month checkup on 2/20/01. She had mild wheezing and was afebrile. She was given MMR, Varivax and Prevnar #2. She was treated with albuterol syrup and Zithromax. She had a cardiopulmonary arrest on 2/23/01. Is there a correlation between mild wheezing, any of the vaccines, the medications used and sudden death? Pt had unexplained cardiopulmonary arrest and expired. Autopsy also states bruise right side of forehead, congestion, pulmonary edema. Cause of death given as acute bronchitis.


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