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This is VAERS ID 416893

Case Details

VAERS ID: 416893 (history)  
Form: Version 1.0  
Age: 3.0  
Sex: Female  
Location: Colorado  
Vaccinated:2011-02-02
Onset:2011-02-07
   Days after vaccination:5
Submitted: 2011-02-15
   Days after onset:8
Entered: 2011-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3665AA / 2 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0285Z / 1 RL / SC
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0834Z / 1 RL / SC

Administered by: Public       Purchased by: Public
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2011-02-07
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: denied by parent
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: apparently found dead in bed by parent


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