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This is VAERS ID 106427

(NOTE: This result is from the 12/31/2003 version of the VAERS database)

Case Details

VAERS ID: 106427 (history)  
Form: Version .0  
Age: 46.9  
Sex: Male  
Location: Tennessee  
Vaccinated:1997-10-03
Onset:0000-00-00
Submitted: 1997-11-21
Entered: 1998-01-20
   Days after submission:60
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: ENGERIX-B / SMITHKLINE 230086 / 1 LA / IM

Administered by: Other       Purchased by: Unknown
Symptoms: REACT UNEVAL
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1997-10-07
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications:
Current Illness: NONE
Preexisting Conditions: diabetes
Allergies:
Diagnostic Lab Data:
CDC Split Type: diabetes

Write-up:


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=106427


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