National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 108787

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

Case Details

VAERS ID: 108787 (history)  
Form: Version .0  
Age: 0.4  
Sex: Female  
Location: North Carolina  
Vaccinated:1998-01-28
Onset:1998-01-28
   Days after vaccination:0
Submitted: 1998-03-12
   Days after onset:43
Entered: 1998-03-24
   Days after submission:12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: ACEL-IMUNE / LEDERLE 446956 / 1 LL / IM
HIBV: HIBTITER / LEDERLE(PRAXIS) M260RJ / 1 RL / IM
IPV: POLIOVAX / CONNAUGHT LTD M11891 / - - / -

Administered by: Military       Purchased by: Unknown
Symptoms: EDEMA BRAIN, HEM, MENINGITIS
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1998-02-07
   Days after onset: 10
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: APAP PRN
Current Illness: cold sx
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: patient died;COD unk by reporter;


New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=108787


Copyright © 2020 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166