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This is VAERS ID 25534

(NOTE: This result is from the 6/14/2018 version of the VAERS database)

Case Details

VAERS ID: 25534 (history)  
Form: Version 1.0  
Age: 4.0  
Sex: Female  
Location: New York  
Vaccinated:1987-12-09
Onset:1990-06-25
   Days after vaccination:929
Submitted: 0000-00-00
Entered: 1990-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HBPV: HIB POLYSACCHARIDE (HIBIMUNE) / PFIZER/WYETH 181666 / UNK - / -

Administered by: Private       Purchased by: Unknown
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1990-06-25
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: 9001160.01

Write-up: 4 1/2 yr old child 25Jun90/w positive blood culture for h. Influenzae type B. Child received immunization on 9Dec87


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20180614&IDNUMBER=25534


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