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This is VAERS ID 28546

Case Details

VAERS ID: 28546 (history)  
Form: Version 1.0  
Age: 3.0  
Sex: Male  
Location: D.C.  
Vaccinated:1990-05-24
Onset:1990-05-26
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 1991-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 8L01023 / UNK RA / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Infection, Meningitis
SMQs:, Noninfectious meningitis (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
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: not available
Allergies:
Diagnostic Lab Data: not available
CDC Split Type: CO3506

Write-up: Pt died; Meningococcal meningitis; Culture proven Neissera;


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