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This is VAERS ID 112192

(NOTE: This result is from the 9/14/2017 version of the VAERS database)

Case Details

VAERS ID: 112192 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Male  
Location: Mississippi  
Vaccinated:1998-03-12
Onset:1998-03-14
   Days after vaccination:2
Submitted: 1998-05-01
   Days after onset:47
Entered: 1998-06-26
   Days after submission:56
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 7B91821 / 1 LL / -
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 0571E / 1 RL / -
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. M1070 / 1 RL / -

Administered by: Public       Purchased by: Public
Symptoms: Stupor, Sudden infant death syndrome
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Neonatal disorders (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1998-03-14
   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: unk
Current Illness: NONE
Preexisting Conditions: NONE-rash on face-oily-probably secondary to immature sweat gland
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type: MS98008

Write-up: mom states tried to wake pt 14MAR98 but pt did not wake up;pt okay when went to sleep;


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20170914&IDNUMBER=112192


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