National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 112467

(NOTE: This result is from the 12/8/2009 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: 1998-07-13
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 0 - / -
HEP: HEP B (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 0 - / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 0 - / -

Administered by: Public       Purchased by: Other
Symptoms: Agitation, Chills, Constipation, Crying, Diarrhoea, Injection site hypersensitivity, Injection site oedema, Somnolence
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Depression (excl suicide and self injury) (broad)

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


New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20091208&IDNUMBER=112467


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