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This is VAERS ID 61523

(NOTE: This result is from the 5/14/2017 version of the VAERS database)

Case Details

VAERS ID: 61523 (history)  
Form: Version .0  
Age: 9.0  
Sex: Female  
Location: Foreign  
Vaccinated:1993-08-24
Onset:1993-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 1994-04-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DT: DT ADSORBED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 - / -
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / - - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / - - / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Unevaluable event
SMQs:

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: Lioresal, Lamictal, Trileptal;
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: 940021301

Write-up: 25AUG93 1 day p/vax pt exp sudden death; The reporter stated that event was possibly related to the vax; No further will be available;


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20170514&IDNUMBER=61523


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