National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 108799

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

Case Details

VAERS ID: 108799 (history)  
Form: Version .0  
Age: 0.3  
Sex: Male  
Location: Washington  
Vaccinated:1998-03-17
Onset:1998-03-18
   Days after vaccination:1
Submitted: 1998-03-18
   Days after onset:0
Entered: 1998-03-24
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: TRIPEDIA / CONNAUGHT LABS 7B91821 / 1 LL / -
HIBV: PEDVAXHIB / MSD 1484E / 1 RL / -
IPV: IPV / MERIEUX INST M1070 / 1 RL / SC

Administered by: Private       Purchased by: Unknown
Symptoms: AGITATION, CHILLS, MONILIA ORAL, OTITIS MED, SIDS
SMQs:, Neonatal disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1998-03-18
   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: Amox given 17MAR98;Nystatin oral susp
Current Illness: URI & OM
Preexisting Conditions: eczema & seborrhea dermatitis
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: pt found deceased in crib this AM <24hr p/vax;


New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=108799


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