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This is VAERS ID 30447

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 30447
VAERS Form:
Age:4.0
Sex:Unknown
Location:Illinois
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1991-04-12
Entered:1991-05-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HBPV: HIBIMUNE / LEDERLE 184666 / - - / -

Administered by: Public      Purchased by: Unknown
Symptoms: REACT UNEVAL

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: NONE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: 4yo child died fr Haemophilus Meningitis 1991; Immunized 2 yrs ago in 1989;


Changed on 12/8/2009

VAERS ID: 30447 Before After
VAERS Form:
Age:4.0
Sex:Unknown
Location:Illinois
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1991-04-12
Entered:1991-05-16 1991-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HBPV: HIBIMUNE HIB POLYSACCHARIDE (HIBIMUNE) / LEDERLE LEDERLE LABORATORIES 184666 / - - / -

Administered by: Public      Purchased by: Unknown Other
Symptoms: Unevaluable event, REACT UNEVAL

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: NONE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': (blank) 910080301

Write-up: 4yo child died fr Haemophilus Meningitis 1991; Immunized 2 yrs ago in 1989;


Changed on 5/14/2017

VAERS ID: 30447 Before After
VAERS Form:
Age:4.0
Sex:Unknown
Location:Illinois
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1991-04-12
Entered:1991-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HBPV: HIB POLYSACCHARIDE (HIBIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 184666 / - - / -

Administered by: Public      Purchased by: Other
Symptoms: Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: NONE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': 910080301

Write-up: 4yo child died fr Haemophilus Meningitis 1991; Immunized 2 yrs ago in 1989;


Changed on 9/14/2017

VAERS ID: 30447 Before After
VAERS Form:(blank) 1
Age:4.0
Sex:Unknown
Location:Illinois
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1991-04-12
Entered:1991-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HBPV: HIB POLYSACCHARIDE (HIBIMUNE) / PFIZER/WYETH 184666 / - UNK - / -

Administered by: Public      Purchased by: Other
Symptoms: Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: NONE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': 910080301

Write-up: 4yo child died fr Haemophilus Meningitis 1991; Immunized 2 yrs ago in 1989;


Changed on 2/14/2018

VAERS ID: 30447 Before After
VAERS Form:1
Age:4.0
Sex:Unknown
Location:Illinois
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1991-04-12
Entered:1991-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HBPV: HIB POLYSACCHARIDE (HIBIMUNE) / PFIZER/WYETH 184666 / UNK - / -

Administered by: Public      Purchased by: Other
Symptoms: Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: NONE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': 910080301

Write-up: 4yo child died fr Haemophilus Meningitis 1991; Immunized 2 yrs ago in 1989;


Changed on 6/14/2018

VAERS ID: 30447 Before After
VAERS Form:1
Age:4.0
Sex:Unknown
Location:Illinois
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1991-04-12
Entered:1991-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HBPV: HIB POLYSACCHARIDE (HIBIMUNE) / PFIZER/WYETH 184666 / UNK - / -

Administered by: Public      Purchased by: Other
Symptoms: Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: NONE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': 910080301

Write-up: 4yo child died fr Haemophilus Meningitis 1991; Immunized 2 yrs ago in 1989;


Changed on 8/14/2018

VAERS ID: 30447 Before After
VAERS Form:1
Age:4.0
Sex:Unknown
Location:Illinois
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1991-04-12
Entered:1991-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HBPV: HIB POLYSACCHARIDE (HIBIMUNE) / PFIZER/WYETH 184666 / UNK - / -

Administered by: Public      Purchased by: Other
Symptoms: Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: NONE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': 910080301

Write-up: 4yo child died fr Haemophilus Meningitis 1991; Immunized 2 yrs ago in 1989;


Changed on 9/14/2018

VAERS ID: 30447 Before After
VAERS Form:1
Age:4.0
Sex:Unknown
Location:Illinois
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1991-04-12
Entered:1991-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HBPV: HIB POLYSACCHARIDE (HIBIMUNE) / PFIZER/WYETH 184666 / UNK - / -

Administered by: Public      Purchased by: Other
Symptoms: Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: NONE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': 910080301

Write-up: 4yo child died fr Haemophilus Meningitis 1991; Immunized 2 yrs ago in 1989;


Changed on 10/14/2018

VAERS ID: 30447 Before After
VAERS Form:1
Age:4.0
Sex:Unknown
Location:Illinois
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1991-04-12
Entered:1991-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HBPV: HIB POLYSACCHARIDE (HIBIMUNE) / PFIZER/WYETH 184666 / UNK - / -

Administered by: Public      Purchased by: Other
Symptoms: Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: NONE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': 910080301

Write-up: 4yo child died fr Haemophilus Meningitis 1991; Immunized 2 yrs ago in 1989;

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