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This is VAERS ID 67195

Case Details

VAERS ID: 67195 (history)  
Form: Version 1.0  
Age: 1.3  
Sex: Male  
Location: Foreign  
Vaccinated:1994-08-11
Onset:1994-08-11
   Days after vaccination:0
Submitted: 1994-10-03
   Days after onset:53
Entered: 1994-10-11
   Days after submission:8
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / IM A

Administered by: Unknown       Purchased by: Unknown
Symptoms: Asthma, Dyspnoea, Sudden infant death syndrome
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Neonatal disorders (narrow), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: none;
Current Illness: none;
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: none;
CDC Split Type: WAES94090729

Write-up: pt recvd vax & in the eve exp 1 episode of wheezing; dx as respiratory distress; pt found dead at 3am morning of 12aug94; cause of death determined to be sids;


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