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This is VAERS ID 42039

Case Details

VAERS ID: 42039 (history)  
Form: Version 1.0  
Age: 1.7  
Sex: Female  
Location: Texas  
Vaccinated:1992-02-25
Onset:1992-03-07
   Days after vaccination:11
Submitted: 1992-05-11
   Days after onset:64
Entered: 1992-05-18
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH M570HJ / UNK RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1636T / UNK LL / SC

Administered by: Public       Purchased by: Public
Symptoms: Arrhythmia, Hypertrophy, Myocardial fibrosis, Sudden infant death syndrome
SMQs:, Cardiomyopathy (narrow), Cardiac arrhythmia terms, nonspecific (narrow), Neonatal disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1992-03-07
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: hx of apical muscular ventricular septal defect
Allergies:
Diagnostic Lab Data:
CDC Split Type: TX92110

Write-up: Sudden death w/no etiology @ autopsy; unclear as to whether it is related to vax;


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