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This is VAERS ID 27510

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 27510
VAERS Form:
Age:0.2
Sex:Female
Location:California
Vaccinated:1990-12-21
Onset:1990-12-22
Submitted:1991-01-16
Entered:1991-01-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIBTITER / LEDERLE(PRAXIS) M730FF / 0 RL / -

Administered by: Private      Purchased by: Unknown
Symptoms: APNEA, EDEMA LUNG, EDEMA BRAIN, ABDO ENLARGE, HEM

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-12-22
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Pedi-Care Decongestant Drops
Current Illness: Decongested
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt given HIB titer 21DEC90 aprox 1230PM pt died 22DEC90 738 HRS.F/U 19Apr91 Autopsy rept-Acute respiratory failure,SIDS.Petechial hemorrhages of pleurae,epicardium & thymus.Pulmonary/cerebral edema &congestion.Congestion of abdo viscera.


Changed on 12/8/2009

VAERS ID: 27510 Before After
VAERS Form:
Age:0.2
Sex:Female
Location:California
Vaccinated:1990-12-21
Onset:1990-12-22
Submitted:1991-01-16
Entered:1991-01-24 1991-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIBTITER HIB (HIBTITER) / LEDERLE(PRAXIS) LEDERLE PRAXSIS M730FF / 0 RL / -

Administered by: Private      Purchased by: Unknown
Symptoms: Abdominal distension, Apnoea, Haemothorax, Lung disorder, Pulmonary oedema, Sudden infant death syndrome, Brain oedema, Haemorrhage, APNEA, EDEMA LUNG, EDEMA BRAIN, ABDO ENLARGE, HEM

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-12-22
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Pedi-Care Decongestant Drops
Current Illness: Decongested
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt given HIB titer 21DEC90 aprox 1230PM pt died 22DEC90 738 HRS.F/U 19Apr91 Autopsy rept-Acute respiratory failure,SIDS.Petechial hemorrhages of pleurae,epicardium & thymus.Pulmonary/cerebral edema &congestion.Congestion of abdo viscera.


Changed on 5/14/2017

VAERS ID: 27510 Before After
VAERS Form:
Age:0.2
Sex:Female
Location:California
Vaccinated:1990-12-21
Onset:1990-12-22
Submitted:1991-01-16
Entered:1991-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / LEDERLE PRAXSIS PFIZER/WYETH M730FF / 0 RL / -

Administered by: Private      Purchased by: Unknown
Symptoms: Abdominal distension, Apnoea, Haemothorax, Lung disorder, Pulmonary oedema, Sudden infant death syndrome, Brain oedema, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-12-22
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Pedi-Care Decongestant Drops
Current Illness: Decongested
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt given HIB titer 21DEC90 aprox 1230PM pt died 22DEC90 738 HRS.F/U 19Apr91 Autopsy rept-Acute respiratory failure,SIDS.Petechial hemorrhages of pleurae,epicardium & thymus.Pulmonary/cerebral edema &congestion.Congestion of abdo viscera.


Changed on 9/14/2017

VAERS ID: 27510 Before After
VAERS Form:(blank) 1
Age:0.2
Sex:Female
Location:California
Vaccinated:1990-12-21
Onset:1990-12-22
Submitted:1991-01-16
Entered:1991-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH M730FF / 0 1 RL / -

Administered by: Private      Purchased by: Unknown
Symptoms: Abdominal distension, Apnoea, Haemothorax, Lung disorder, Pulmonary oedema, Sudden infant death syndrome, Brain oedema, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-12-22
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Pedi-Care Decongestant Drops
Current Illness: Decongested
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt given HIB titer 21DEC90 aprox 1230PM pt died 22DEC90 738 HRS.F/U 19Apr91 Autopsy rept-Acute respiratory failure,SIDS.Petechial hemorrhages of pleurae,epicardium & thymus.Pulmonary/cerebral edema &congestion.Congestion of abdo viscera.


Changed on 2/14/2018

VAERS ID: 27510 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:California
Vaccinated:1990-12-21
Onset:1990-12-22
Submitted:1991-01-16
Entered:1991-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH M730FF / 1 RL / -

Administered by: Private      Purchased by: Unknown
Symptoms: Abdominal distension, Apnoea, Haemothorax, Lung disorder, Pulmonary oedema, Sudden infant death syndrome, Brain oedema, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-12-22
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Pedi-Care Decongestant Drops
Current Illness: Decongested
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt given HIB titer 21DEC90 aprox 1230PM pt died 22DEC90 738 HRS.F/U 19Apr91 Autopsy rept-Acute respiratory failure,SIDS.Petechial hemorrhages of pleurae,epicardium & thymus.Pulmonary/cerebral edema &congestion.Congestion of abdo viscera.


Changed on 6/14/2018

VAERS ID: 27510 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:California
Vaccinated:1990-12-21
Onset:1990-12-22
Submitted:1991-01-16
Entered:1991-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH M730FF / 1 RL / -

Administered by: Private      Purchased by: Unknown
Symptoms: Abdominal distension, Apnoea, Haemothorax, Lung disorder, Pulmonary oedema, Sudden infant death syndrome, Brain oedema, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-12-22
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Pedi-Care Decongestant Drops
Current Illness: Decongested
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt given HIB titer 21DEC90 aprox 1230PM pt died 22DEC90 738 HRS.F/U 19Apr91 Autopsy rept-Acute respiratory failure,SIDS.Petechial hemorrhages of pleurae,epicardium & thymus.Pulmonary/cerebral edema &congestion.Congestion of abdo viscera.


Changed on 8/14/2018

VAERS ID: 27510 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:California
Vaccinated:1990-12-21
Onset:1990-12-22
Submitted:1991-01-16
Entered:1991-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH M730FF / 1 RL / -

Administered by: Private      Purchased by: Unknown
Symptoms: Abdominal distension, Apnoea, Haemothorax, Lung disorder, Pulmonary oedema, Sudden infant death syndrome, Brain oedema, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-12-22
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Pedi-Care Decongestant Drops
Current Illness: Decongested
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt given HIB titer 21DEC90 aprox 1230PM pt died 22DEC90 738 HRS.F/U 19Apr91 Autopsy rept-Acute respiratory failure,SIDS.Petechial hemorrhages of pleurae,epicardium & thymus.Pulmonary/cerebral edema &congestion.Congestion of abdo viscera.


Changed on 9/14/2018

VAERS ID: 27510 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:California
Vaccinated:1990-12-21
Onset:1990-12-22
Submitted:1991-01-16
Entered:1991-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH M730FF / 1 RL / -

Administered by: Private      Purchased by: Unknown
Symptoms: Abdominal distension, Apnoea, Haemothorax, Lung disorder, Pulmonary oedema, Sudden infant death syndrome, Brain oedema, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-12-22
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Pedi-Care Decongestant Drops
Current Illness: Decongested
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt given HIB titer 21DEC90 aprox 1230PM pt died 22DEC90 738 HRS.F/U 19Apr91 Autopsy rept-Acute respiratory failure,SIDS.Petechial hemorrhages of pleurae,epicardium & thymus.Pulmonary/cerebral edema &congestion.Congestion of abdo viscera.


Changed on 10/14/2018

VAERS ID: 27510 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:California
Vaccinated:1990-12-21
Onset:1990-12-22
Submitted:1991-01-16
Entered:1991-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH M730FF / 1 RL / -

Administered by: Private      Purchased by: Unknown
Symptoms: Abdominal distension, Apnoea, Haemothorax, Lung disorder, Pulmonary oedema, Sudden infant death syndrome, Brain oedema, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-12-22
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Pedi-Care Decongestant Drops
Current Illness: Decongested
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt given HIB titer 21DEC90 aprox 1230PM pt died 22DEC90 738 HRS.F/U 19Apr91 Autopsy rept-Acute respiratory failure,SIDS.Petechial hemorrhages of pleurae,epicardium & thymus.Pulmonary/cerebral edema &congestion.Congestion of abdo viscera.

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