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This is VAERS ID 112467

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

Case Details

VAERS ID: 112467 (history)  
Form: Version .0  
Age: 0.4  
Sex: Female  
Location: California  
Vaccinated:1998-04-22
Onset:1998-04-23
   Days after vaccination:1
Submitted: 1998-07-09
   Days after onset:77
Entered: 1998-07-14
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: UNK. DTP / UNCLASSIFIED - / 0 - / -
HEP: UNK. HEPATITIS B / UNCLASSIFIED - / 1 - / -
HIBV: UNK. HAEMOPHILUS B / UNCLASSIFIED - / 0 - / -
OPV: UNK. POLIOVIRUS LIVE ORAL TRIVALENT / UNCLASSIFIED - / 0 - / -

Administered by: Public       Purchased by: Unknown
Symptoms: AGITATION, CHILLS, CONSTIP, CRY ABNORMAL, DIARRHEA
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1998-04-26
   Days after onset: 3
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: APAP
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: w/in 7hr site of inj was swollen & reddish for next 12hr pt alternately screamed inconsolably & fell into a deep sleep, next day had diarrhea & tool longer to finish bottles, as day went by skin felt cold to touch;pt later died;constipation


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=112467


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