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This is VAERS ID 151621

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

Case Details

VAERS ID: 151621 (history)  
Form: Version .0  
Age: 0.2  
Sex: Male  
Location: Connecticut  
Vaccinated:2000-05-02
Onset:2000-05-03
   Days after vaccination:1
Submitted: 2000-05-03
   Days after onset:0
Entered: 2000-05-05
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: TRIPEDIA / CONNAUGHT LABS U0045BA / 0 RL / IM
HIBV: HIBTITER / LEDERLE(PRAXIS) 56092A / 0 RL / IM
IPV: IPV / MERIEUX INST R0100 / 0 LL / SC

Administered by: Private       Purchased by: Unknown
Symptoms: APNEA, HEART ARREST, SIDS
SMQs:, Neonatal disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2000-05-03
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Previous rule/out Sepsis with/out dx viral
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Found apneic and asystolic, tied up in blankets 24 hours after vax. Autopsy shows final cause of death as sudden infant death syndrome.


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=151621


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