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This is VAERS ID 53621

Case Details

VAERS ID: 53621 (history)  
Form: Version 1.0  
Age: 1.6  
Sex: Female  
Location: New York  
   Days after vaccination:14
Submitted: 1993-06-04
   Days after onset:4118
Entered: 1993-06-07
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Brain oedema, Cardiac arrest, Dehydration, Diabetic coma, Faecaloma, Infection, Ketosis, Pancreatic disorder
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (broad), Hyponatraemia/SIADH (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Respiratory failure (broad), Dehydration (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1982-04-08
   Days after onset: 44
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: common cold; Roseola;
Diagnostic Lab Data: 8APR82 Autopsy-death determined to be diabetic ketoacidosis & coma; pancreas found to be virus infected;
CDC Split Type: WAES93050798

Write-up: pt recvd vax 9FEB82 & on 23FEB82 devel diabetic sx: excessive urination & thirst; parents did not recognize sx until pt went into coma 7APR92 following day pt died; pt was dehydrated w/early fecal impaction, pancreatic edema; cerebral edema

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