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This is VAERS ID 106325

Case Details

VAERS ID: 106325 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Female  
Location: Missouri  
Vaccinated:1998-01-09
Onset:1998-01-11
   Days after vaccination:2
Submitted: 1998-01-12
   Days after onset:1
Entered: 1998-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 7H81507 / 1 LL / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 7D91713 / 1 RL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. M0359 / 1 LL / IM

Administered by: Private       Purchased by: Public
Symptoms: Unevaluable event
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1998-01-11
   Days after onset: 0
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:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: found dead in bed approx 06:00 11JAN98;


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