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This is VAERS ID 97015

Case Details

VAERS ID: 97015 (history)  
Form: Version 1.0  
Age: 1.3  
Sex: Male  
Location: New Hampshire  
Vaccinated:1996-12-30
Onset:1997-01-10
   Days after vaccination:11
Submitted: 1997-01-14
   Days after onset:4
Entered: 1997-04-21
   Days after submission:96
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1418B / 2 LL / -

Administered by: Private       Purchased by: Public
Symptoms: Dehydration, Sudden infant death syndrome
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neonatal disorders (narrow), Dehydration (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1997-01-10
   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: NONE
Current Illness: laceration
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: autopsy pending;
CDC Split Type: NH97002

Write-up: death 10JAN97 seen 3JAN97 in ER for laceration;


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