National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 275428

(NOTE: This result is from the 12/31/2007 version of the VAERS database)

Case Details

VAERS ID: 275428 (history)  
Form: Version .0  
Age: 12.0  
Gender: Female  
Location: New York  
Vaccinated:2007-03-01
Onset:2007-03-07
   Days after vaccination:6
Submitted: 2007-04-02
   Days after onset:25
Entered: 2007-04-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 1280F / 1 RA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0263U / 0 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0943R / 1 RA / SC

Administered by: Unknown       Purchased by: Unknown
Symptoms: Abdominal pain, Acidosis, Alanine aminotransferase increased, Aspartate aminotransferase increased, Autopsy
SMQs:, Liver related investigations, signs and symptoms (narrow), Acute pancreatitis (broad), Lactic acidosis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2007-03-08
   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: none
Preexisting Conditions: aortic and mitral valve insufficiency, unknown aetiology
Allergies:
Diagnostic Lab Data: ER LABS of 3/8/07: ABG pH 7.23, po2 62. Serum glucose 353, Creat 1.7, albumin 2.6, total protein 4.9, SGPT 62, SGOT 359. Blood c/s was neg. 2005 Cardiology LABS: echocardiogram revealed mild mitral valve & aortic valve insufficiency. Mi
CDC Split Type:

Write-up: presented to ED with Ventricular tachycardia. Preliminary autopsy finding of myocarditis


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20071231&IDNUMBER=275428


Copyright © 2017 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166