National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 160612

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

Case Details

VAERS ID: 160612 (history)  
Form: Version .0  
Age: 0.2  
Sex: Male  
Location: Florida  
Vaccinated:1997-11-11
Onset:1997-11-12
   Days after vaccination:1
Submitted: 2000-10-10
   Days after onset:1062
Entered: 2000-10-18
   Days after submission:8
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: UNK. DTAP / UNCLASSIFIED 7HB1507 / 0 - / IM
HEP: UNK. HEPATITIS B / UNCLASSIFIED 00727 / 0 - / IM
HIBV: UNK. HAEMOPHILUS B / UNCLASSIFIED M305PB / 0 - / IM
OPV: UNK. POLIOVIRUS LIVE ORAL TRIVALENT / UNCLASSIFIED - / 0 - / PO

Administered by: Private       Purchased by: Unknown
Symptoms: AGITATION, APNEA, CONVULS, CRY ABNORMAL, DIARRHEA
SMQs:

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 1997-11-29
   Days after onset: 17
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Pedialyte, Children''s Tylenol
Current Illness: Pneumonia, unresolved RDS, Meningeal infection
Preexisting Conditions: Prematurity, RDS, Hyperbilirubinemia, Gestational diabetes, induced labor, E-Coli, others, meningeal infection, failure to thrive, NRBC''s
Allergies:
Diagnostic Lab Data: Hematological, UA, Chemical Profile, coagulation, culture, Glucose increased, liver-increased multiple abnormalties, Platelet increased, Anion Gap increased, Creatine decreased, Phos increased, and many more.
CDC Split Type:

Write-up: Fever, apnea, vomiting, diarrhea, feeding problems, grunting, high-pitched crying, possible seizures, lethargy with onset at 24 to 48 hours, possibly sooner. 10 days later, symptoms worsening gradually. At 10:00 on 11/24/1997, pt in respiratory arrest, re"suscitated, life support with CT Scan revealing ICH, DAT, hypoxia, ischemia, pneumonia, meningeal inflection, others. Life support terminated 11/29/1997.


New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=160612


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