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This is VAERS ID 116883

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

Case Details

VAERS ID: 116883 (history)  
Form: Version .0  
Age: 1.2  
Sex: Female  
Location: California  
Vaccinated:1998-04-24
Onset:1998-04-28
   Days after vaccination:4
Submitted: 1998-11-02
   Days after onset:188
Entered: 1998-11-30
   Days after submission:28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: TRIPEDIA / CONNAUGHT LABS 0927950 / 0 - / IM
HIBV: PROHIBIT / CONNAUGHT LABS 0927950 / 0 - / IM
MMR: MMR II / MSD 0026H / 0 - / -

Administered by: Private       Purchased by: Unknown
Symptoms: BRADYCARDIA, CYANOSIS, DEHYDRAT, DIARRHEA, EDEMA LUNG
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1998-04-30
   Days after onset: 2
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: autopsy revealed dehydration w/moderate WBC''s in CSF;
CDC Split Type: NONE

Write-up: child devel gastroenteritis 4 days p/vax; probably unrelated-devel worsening emesis & diarrhea over 2 days;despite intervention, pt subsequently went into shock & was taken to ER blue & pulseless;


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=116883


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