National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 152670

(NOTE: This result is from the 5/14/2017 version of the VAERS database)

Case Details

VAERS ID: 152670 (history)  
Form: Version .0  
Age: 1.08  
Sex: Female  
Location: Massachusetts  
Vaccinated:2000-05-15
Onset:2000-05-25
   Days after vaccination:10
Submitted: 2000-05-30
   Days after onset:5
Entered: 2000-06-06
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH 560903A / 3 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1275J / 0 RL / SC

Administered by: Private       Purchased by: Public
Symptoms: Atelectasis, Brain oedema, Liver disorder, Pallor, Pharyngitis, Pneumonia, Pulmonary congestion, Pyrexia, Rash macular, Respiratory failure, Rhinitis
SMQs:, Cardiac failure (broad), Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Anaphylactic reaction (broad), Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Oropharyngeal infections (narrow), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Hyponatraemia/SIADH (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2000-05-28
   Days after onset: 3
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PPD - Lot number 0090P, ID, RA
Current Illness: NONE
Preexisting Conditions: febrile seizures, pneumococcal bacteremia
Allergies:
Diagnostic Lab Data: CBC-5500
CDC Split Type:

Write-up: on 5/25/00, pt had fever, cold symptoms for 2 days, runny nose, red pharynx, a few papules on face, WBC 5,500. 5/27 via phone call, pt was pale, had macular rash on nose and face, fever was 100.8. Pt was taken to ER on 5/28. DOA, (probably several hours). Autopsy states liver congestion, lung atelectasis, lung congestion, respiratory failure due to streptococcal (group B) pneumonia, ceberal edema,


New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20170514&IDNUMBER=152670


Copyright © 2020 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166