National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 110712

(NOTE: This result is from the 4/14/2019 version of the VAERS database)

Case Details

VAERS ID: 110712 (history)  
Form: Version 1.0  
Age: 23.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:1998-01-15
Onset:1998-01-30
   Days after vaccination:15
Submitted: 1998-05-05
   Days after onset:94
Entered: 1998-05-11
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
TD: TD ADSORBED (TDVAX) / MASS. PUB HLTH BIOL LAB TD61 / UNK - / -

Administered by: Private       Purchased by: Other
Symptoms: Condition aggravated, Convulsion
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1998-01-30
   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: Dilantin;Tegretol
Current Illness: Epilepsy
Preexisting Conditions: epilepsy
Allergies:
Diagnostic Lab Data: medical autopsy found no other abnormalities. The autopsy report states seizure disorder.
CDC Split Type:

Write-up: 14 days p/vax pt died of sz disorder;had 2yr hx of sz, most recently determined to be epilepsy. The autopsy report states seizure disorder.


New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20190414&IDNUMBER=110712


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