National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 12/31/2003 release of VAERS data (an older release, current is 6/11/2021):

This is VAERS ID 133412



Case Details

VAERS ID: 133412 (history)  
Form: Version .0  
Age: 0.2  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2000-01-03
Onset:2000-01-06
   Days after vaccination:3
Submitted: 2000-01-12
   Days after onset:6
Entered: 2000-01-23
   Days after submission:11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: TRIPEDIA / CONNAUGHT LABS 7387AA / 0 RL / IM
HEP: RECOMBIVAX HB / MSD 1527J / 0 LL / IM
HIBV: ACT-HIB / CONNAUGHT LABS UA462AB / 0 LL / IM
IPV: IPV / MERIEUX INST N04911 / 0 RL / SC

Administered by: Private       Purchased by: Unknown
Symptoms: APNEA, CONVULS, CYANOSIS, HYPOTONIA, HYPOXIA
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: LP-normal, CT scan - slight promonence of ventricles, EEG - normal
CDC Split Type:

Write-up: Pt developed episodes of cyanosis associated with apnea, low O2 sats and staring, limpness - dx seizures seen in ER on 1/8/00, parents stated some blueness around lips noted 36 hrs before being seen.


New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=133412


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166