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This is VAERS ID 72450

(NOTE: This result is from the 9/14/2018 version of the VAERS database)

Case Details

VAERS ID: 72450 (history)  
Form: Version 1.0  
Age: 1.3  
Sex: Male  
Location: Foreign  
Vaccinated:1995-02-20
Onset:1995-02-21
   Days after vaccination:1
Submitted: 1995-03-23
   Days after onset:30
Entered: 1995-03-28
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DT: DT ADSORBED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Agitation, Bronchitis, Cough, Infection, Pneumonia, Pyrexia, Sepsis
SMQs:, Anaphylactic reaction (broad), Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1995-02-22
   Days after onset: 1
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: cough syrup
Current Illness:
Preexisting Conditions: no relevant history
Allergies:
Diagnostic Lab Data: blood test-streptococcus pneumonia;
CDC Split Type: WAES95030780

Write-up: pt recvd vax & had a sl cough & cough medicine was prescribed; On 21FEB95 & exp fever of 38.6 to 38.7; 22FEB95 woke in the morning crying; went to sleep again 1hr later found dead; tracheobronchitis; streptococcus pneumonia, type 10A found


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20180914&IDNUMBER=72450


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