This is VAERS ID 108795

(NOTE: This result is from the 5/14/2017 version of the VAERS database)

Case Details

VAERS ID:	108795 (history)
Form:	Version .0
Age:	0.0
Sex:	Female
Location:	New Hampshire

Vaccinated:	1996-04-13
Onset:	1996-04-28
Days after vaccination:	15
Submitted:	1998-03-19
Days after onset:	690
Entered:	1998-03-24
Days after submission:	5

Vaccination / Manufacturer	Lot / Dose	Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC.	1163A / 0	RL / -

Administered by: Private Purchased by: Public
Symptoms: Congenital anomaly, Cyst, Sudden infant death syndrome, Unevaluable event
SMQs:, Congenital, familial and genetic disorders (narrow), Neonatal disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 1996-04-28
Days after onset: 0
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: NONE
Allergies:
Diagnostic Lab Data:
CDC Split Type: NH9634

Write-up: SIDS

New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20170514&IDNUMBER=108795