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This is VAERS ID 113661

(NOTE: This result is from the 6/14/2018 version of the VAERS database)

Case Details

VAERS ID: 113661 (history)  
Form: Version 1.0  
Age: 1.3  
Sex: Female  
Location: Unknown  
Vaccinated:1998-05-11
Onset:1998-05-16
   Days after vaccination:5
Submitted: 1998-08-24
   Days after onset:100
Entered: 1998-08-27
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Cardiovascular disorder, Condition aggravated, Hepatitis, Hypersensitivity, Hypertonia, Meningitis, Vomiting
SMQs:, Hepatitis, non-infectious (narrow), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1998-05-16
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: No relevant data;~ ()~~~In patient
Other Medications: antimicrobial therapy
Current Illness:
Preexisting Conditions: otitis med;upper resp infect
Allergies:
Diagnostic Lab Data: autopsy eosinophils around cardiac vessles;autopsy no viral inclusions in liver;only frontal lobe specimen pos for wild type VZV on PCR analysis;heart & cerebellum high ELISA''s
CDC Split Type: WAES98070287

Write-up: 4 days post vax pt died;mom described child as fussy 15MAY98 w/n/v then becoming rigid in arms & legs;COD originally believe to be myocarditis now feel meningitis;sz, noted hepatitis w/multifocal inflam;allerg react;


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20180614&IDNUMBER=113661


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