National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 162585

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

Case Details

VAERS ID: 162585 (history)  
Form: Version .0  
Age: 0.3  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2000-10-23
Onset:2000-10-23
   Days after vaccination:0
Submitted: 2000-11-17
   Days after onset:25
Entered: 2000-11-27
   Days after submission:10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: TRIPEDIA / CONNAUGHT LABS U0328AB / 0 LL / IM
HIBV: ACT-HIB / CONNAUGHT LABS UA546AA / 0 RL / IM

Administered by: Other       Purchased by: Unknown
Symptoms: ACIDOSIS, APNEA, HEART ARREST, HEART FAIL, LUNG DIS
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2000-10-23
   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: diuretics, Zantac
Current Illness: CHF
Preexisting Conditions: complex cyanotic heart disease, chronic lung disease
Allergies:
Diagnostic Lab Data: chest x-ray, blood gases, autopsy (heart and lungs)
CDC Split Type:

Write-up: 28 4/7 weeks premature infant was given vaccines on 10/23/00 at approximately 9:00. At 12:00 the infant had signs of decreased profusion, shock, malaise, acidosis, and cardiac arrest. Autopsy shows lung congestion. Death stated as caused by repiratory fai"lure secondary to congenital heart failure.


New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=162585


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