National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 120450

(NOTE: This result is from the 9/14/2017 version of the VAERS database)

Case Details

VAERS ID: 120450 (history)  
Form: Version 1.0  
Age: 1.0  
Sex: Female  
Location: Alabama  
Vaccinated:1999-03-10
Onset:1999-03-13
   Days after vaccination:3
Submitted: 1999-03-18
   Days after onset:5
Entered: 1999-03-19
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / SMITHKLINE BEECHAM 865A2 / 3 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH 361453 / 3 RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0734E / 1 LL / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 79413 / 3 MO / PO
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 10524 / 1 LA / SC

Administered by: Public       Purchased by: Public
Symptoms: Apnoea, Bronchiolitis, Cardiac arrest, Hepatomegaly, Laboratory test abnormal, Lymphadenopathy, Myocarditis, Neoplasm, Pneumonia, Pyrexia, Splenomegaly, Vaginal haemorrhage, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Non-haematological tumours of unspecified malignancy (narrow), Infective pneumonia (narrow)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 1999-03-13
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: lt lung culture:Viridans Streptococcus, 2 colonies Candida, Haemophilus, beta lactamase+; rt lung culture: haemophilus, beta lactamase+; Blood culture: Staphylococcus epidermidis
CDC Split Type: AL9904

Write-up: hx of pt arriving in ER in full arrest & expired @ hosp;sl bloody vaginal discharge noted in ER;


New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20170914&IDNUMBER=120450


Copyright © 2019 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166