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This is VAERS ID 112467

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 112467
VAERS Form:
Age:0.4
Sex:Female
Location:California
Vaccinated:1998-04-22
Onset:1998-04-23
Submitted:1998-07-09
Entered:1998-07-14
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, DIARRHEA, CONSTIP, CRY ABNORMAL

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-04-26
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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

Changed on 12/8/2009

VAERS ID: 112467 Before After
VAERS Form:
Age:0.4
Sex:Female
Location:California
Vaccinated:1998-04-22
Onset:1998-04-23
Submitted:1998-07-09
Entered:1998-07-14 1998-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: UNK. DTP DTP (NO BRAND NAME) / UNCLASSIFIED UNKNOWN MANUFACTURER - / 0 - / -
HEP: UNK. HEPATITIS B HEP B (NO BRAND NAME) / UNCLASSIFIED UNKNOWN MANUFACTURER - / 1 - / -
HIBV: UNK. HAEMOPHILUS B HIB (NO BRAND NAME) / UNCLASSIFIED UNKNOWN MANUFACTURER - / 0 - / -
OPV: UNK. POLIOVIRUS LIVE ORAL TRIVALENT POLIO VIRUS, ORAL (NO BRAND NAME) / UNCLASSIFIED UNKNOWN MANUFACTURER - / 0 - / -

Administered by: Public      Purchased by: Unknown Other
Symptoms: Agitation, Chills, Constipation, Crying, Diarrhoea, Injection site hypersensitivity, Injection site oedema, Somnolence, AGITATION, CHILLS, DIARRHEA, CONSTIP, CRY ABNORMAL

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-04-26
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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

Changed on 5/14/2017

VAERS ID: 112467 Before After
VAERS Form:
Age:0.4
Sex:Female
Location:California
Vaccinated:1998-04-22
Onset:1998-04-23
Submitted:1998-07-09
Entered:1998-07-13
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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-04-26
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
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

Changed on 9/14/2017

VAERS ID: 112467 Before After
VAERS Form:(blank) 1
Age:0.4
Sex:Female
Location:California
Vaccinated:1998-04-22
Onset:1998-04-23
Submitted:1998-07-09
Entered:1998-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 0 1 - / -
HEP: HEP B (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 2 - / -
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 0 1 - / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 0 1 - / -

Administered by: Public      Purchased by: Other
Symptoms: Agitation, Chills, Constipation, Crying, Diarrhoea, Injection site hypersensitivity, Injection site oedema, Somnolence

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-04-26
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
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

Changed on 2/14/2018

VAERS ID: 112467 Before After
VAERS Form:1
Age:0.4
Sex:Female
Location:California
Vaccinated:1998-04-22
Onset:1998-04-23
Submitted:1998-07-09
Entered:1998-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -
HEP: HEP B (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 - / -
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -

Administered by: Public      Purchased by: Other
Symptoms: Agitation, Chills, Constipation, Crying, Diarrhoea, Injection site hypersensitivity, Injection site oedema, Somnolence

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-04-26
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
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

Changed on 6/14/2018

VAERS ID: 112467 Before After
VAERS Form:1
Age:0.4
Sex:Female
Location:California
Vaccinated:1998-04-22
Onset:1998-04-23
Submitted:1998-07-09
Entered:1998-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -
HEP: HEP B (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 - / -
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -

Administered by: Public      Purchased by: Other
Symptoms: Agitation, Chills, Constipation, Crying, Diarrhoea, Injection site hypersensitivity, Injection site oedema, Somnolence

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-04-26
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
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

Changed on 8/14/2018

VAERS ID: 112467 Before After
VAERS Form:1
Age:0.4
Sex:Female
Location:California
Vaccinated:1998-04-22
Onset:1998-04-23
Submitted:1998-07-09
Entered:1998-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -
HEP: HEP B (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 - / -
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -

Administered by: Public      Purchased by: Other
Symptoms: Agitation, Chills, Constipation, Crying, Diarrhoea, Injection site hypersensitivity, Injection site oedema, Somnolence

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-04-26
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
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

Changed on 9/14/2018

VAERS ID: 112467 Before After
VAERS Form:1
Age:0.4
Sex:Female
Location:California
Vaccinated:1998-04-22
Onset:1998-04-23
Submitted:1998-07-09
Entered:1998-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -
HEP: HEP B (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 - / -
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -

Administered by: Public      Purchased by: Other
Symptoms: Agitation, Chills, Constipation, Crying, Diarrhoea, Injection site hypersensitivity, Injection site oedema, Somnolence

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-04-26
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
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

Changed on 10/14/2018

VAERS ID: 112467 Before After
VAERS Form:1
Age:0.4
Sex:Female
Location:California
Vaccinated:1998-04-22
Onset:1998-04-23
Submitted:1998-07-09
Entered:1998-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -
HEP: HEP B (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 - / -
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -

Administered by: Public      Purchased by: Other
Symptoms: Agitation, Chills, Constipation, Crying, Diarrhoea, Injection site hypersensitivity, Injection site oedema, Somnolence

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-04-26
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
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

Changed on 12/24/2020

VAERS ID: 112467 Before After
VAERS Form:1
Age:0.4
Sex:Female
Location:California
Vaccinated:1998-04-22
Onset:1998-04-23
Submitted:1998-07-09
Entered:1998-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -
HEP: HEP B (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 - / -
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -

Administered by: Public      Purchased by: Other
Symptoms: Agitation, Chills, Constipation, Crying, Diarrhoea, Injection site hypersensitivity, Injection site oedema, Somnolence

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-04-26
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
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

Changed on 12/30/2020

VAERS ID: 112467 Before After
VAERS Form:1
Age:0.4
Sex:Female
Location:California
Vaccinated:1998-04-22
Onset:1998-04-23
Submitted:1998-07-09
Entered:1998-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -
HEP: HEP B (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 - / -
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -

Administered by: Public      Purchased by: Other
Symptoms: Agitation, Chills, Constipation, Crying, Diarrhoea, Injection site hypersensitivity, Injection site oedema, Somnolence

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-04-26
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
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?IDNUMBER=112467&WAYBACKHISTORY=ON


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