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This is VAERS ID 26668

(NOTE: This result is from the 2/14/2018 version of the VAERS database)

Case Details

VAERS ID: 26668 (history)  
Form: Version 1.0  
Age: 1.4  
Sex: Unknown  
Location: New York  
Vaccinated:1990-11-08
Onset:1990-11-11
   Days after vaccination:3
Submitted: 1990-11-13
   Days after onset:2
Entered: 1990-11-16
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0C21132 / 1 - / IM

Administered by: Private       Purchased by: Private
Symptoms: Bronchitis, Laryngitis, Otitis media, Pharyngitis, Pyrexia
SMQs:, Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1990-11-11
   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: Mild cold
Preexisting Conditions: normal child
Allergies:
Diagnostic Lab Data:
CDC Split Type: CO3705

Write-up: Pt vaccinated with PROHIBIT mild cold at time of injection. Seen again 11NOV for subjective fever, worsening cold tugging at ears. Dx w/Otitis. Prescribed Augmentin, Codeine & Tylenol. Child found dead 6 hrs later in bed. Normal child


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20180214&IDNUMBER=26668


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