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This is VAERS ID 27509

Case Details

VAERS ID: 27509 (history)  
Form: Version 1.0  
Age: 0.3  
Sex: Male  
Location: Alaska  
Vaccinated:1991-01-14
Onset:1991-01-15
   Days after vaccination:1
Submitted: 1991-01-17
   Days after onset:2
Entered: 1991-01-22
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 1726S / 1 LL / IM

Administered by: Public       Purchased by: Public
Symptoms: Apnoea
SMQs:, Acute central respiratory depression (narrow), Respiratory failure (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1991-01-15
   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: Received BPIG (IND drug) by Mass Biologic Labs, Lot #8, IM, RL, 1 prev dose at same time as HIB.
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: autopsy pending
CDC Split Type:

Write-up: Received PRP-OMP & BPIG (IND drug) after being evaluated & found afeb. & in good health. Infant was found apneic in his bed the next AM.


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