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This is VAERS ID 184904

(NOTE: This result is from the 9/14/2017 version of the VAERS database)

Case Details

VAERS ID: 184904 (history)  
Form: Version 1.0  
Age: 2.08  
Sex: Male  
Location: Foreign  
   Days after vaccination:18
Submitted: 2002-05-14
   Days after onset:345
Entered: 2002-05-21
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Unknown       Purchased by: Unknown
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Aspiration, Blood calcium decreased, Blood chloride decreased, Blood creatine phosphokinase increased, Conjunctivitis, Cyanosis, Pyrexia, Sudden infant death syndrome, Upper respiratory tract infection
SMQs:, Rhabdomyolysis/myopathy (broad), Liver related investigations, signs and symptoms (narrow), Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Conjunctival disorders (narrow), Ocular infections (broad), Neonatal disorders (narrow), Hypotonic-hyporesponsive episode (broad), Chronic kidney disease (broad), Hypersensitivity (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2001-06-04
   Days after onset: 1
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:
Preexisting Conditions: Febrile convulsion
Diagnostic Lab Data: CRP-less than 7; leucocytes-6.2; hemoglobin-13.5; thrombocytes-153; neutrophils-1.99; lymphocytes-3.42; monocytes-0.72; cephatest-70H; creatinine-95H; urea-4.6; sodium-139; chloride-84; calcium-1.83; glucose-14.1; plasma aspartate aminotransferase test 1612; plasma alanine aminotransferase test-1132; serum alkaline phosphatase test-375; serum lactate dehydrogenase test-6567; serum creatine kinase test-5424; total protein-62; albumin-39; urine clear; Autopsy-no certain cause of death
CDC Split Type: WAES0205USA00328

Write-up: Information has been received from a health authority concerning a 25 month old male with a history of 2 episodes of uncomplicated fever convulsions who on 5/16/01 was vaccinated with the 1st dose of MMRII (lot unknown). There was no concomitant medication. On 6/4/01, 19 days post vax, the pt was found lifeless in his bed at 11:55 AM on his back with blue lips and vomit in his pharynx. It was reported that he had conjunctivitis the day before, upper respiratory infection for 1 day and a fever of 38.6C, in the morning but seemed unaffected. He went to sleep about 09:30 AM and at 11:30 AM was observed to be sleeping on his stomach. No petechia or other rash was noted. The autopsy showed no certain cause of death and the cause of death was classified as borderline SIDS. It was reported that no findings point to causal relationship to the vaccine. No further information is available.

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