National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 29978

(NOTE: This result is from the 9/14/2017 version of the VAERS database)

Case Details

VAERS ID: 29978 (history)  
Form: Version 1.0  
Age: 1.3  
Sex: Male  
Location: Pennsylvania  
Vaccinated:1991-02-14
Onset:1991-03-10
   Days after vaccination:24
Submitted: 1991-04-16
   Days after onset:36
Entered: 1991-04-19
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH M200FD / 1 RA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1880S / 1 LA / SC

Administered by: Private       Purchased by: Private
Symptoms: Pyrexia, Rhinitis, Sudden infant death syndrome
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Neonatal disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1991-03-10
   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 pt; pale, listless; 2mos, DTP, 1st dose;~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy negative; DX SIDS; No evidence of viral or bacterial infect;
CDC Split Type:

Write-up: Seen on 7MAR91 as mom requested to have TM''s checked; child active & normal 9MAR91 developed sl. fever & rhinorrhea was well except for fever @ 0222 10MAR91 parents heard him in crib 0730 10MAR91; Found dead @ 11AM 10MAR91;


New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20170914&IDNUMBER=29978


Copyright © 2019 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166