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This is VAERS ID 41374

(NOTE: This result is from the 10/14/2018 version of the VAERS database)

Case Details

VAERS ID: 41374 (history)  
Form: Version 1.0  
Age: 1.7  
Sex: Male  
Location: New Hampshire  
Vaccinated:1992-02-26
Onset:1992-03-19
   Days after vaccination:22
Submitted: 1992-03-26
   Days after onset:7
Entered: 1992-04-22
   Days after submission:26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 318907 / 4 RL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M560FP / 2 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0985T / 1 RA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0648E / 4 MO / PO

Administered by: Public       Purchased by: Public
Symptoms: Dehydration, Gastroenteritis
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Noninfectious diarrhoea (broad), Dehydration (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1992-03-21
   Days after onset: 2
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: unk
CDC Split Type: NH92005

Write-up: Unaware of any adverse rxn post vax 26NOV91 & 26FEB92; pt died 21MAR92 w/dehydration, post gastroenteritis x 2 days prior to death; MD called & stated pt had vax less than 1 month ago @ clinic;


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20181014&IDNUMBER=41374


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