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This is VAERS ID 106325

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 106325
VAERS Form:
Age:0.2
Sex:Female
Location:Missouri
Vaccinated:1998-01-09
Onset:1998-01-11
Submitted:1998-01-12
Entered:1998-01-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: TRIPEDIA / CONNAUGHT LABS 7H81507 / 0 LL / IM
HIBV: PROHIBIT / CONNAUGHT LABS 7D91713 / 0 RL / IM
IPV: POLIOVAX / CONNAUGHT LTD M0359 / 0 LL / IM

Administered by: Private      Purchased by: Unknown
Symptoms: REACT UNEVAL

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-01-11
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': NONE

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


Changed on 12/8/2009

VAERS ID: 106325 Before After
VAERS Form:
Age:0.2
Sex:Female
Location:Missouri
Vaccinated:1998-01-09
Onset:1998-01-11
Submitted:1998-01-12
Entered:1998-01-14 1998-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: TRIPEDIA DTAP (TRIPEDIA) / CONNAUGHT LABS CONNAUGHT LABORATORIES 7H81507 / 0 LL / IM
HIBV: PROHIBIT HIB (PROHIBIT) / CONNAUGHT LABS CONNAUGHT LABORATORIES 7D91713 / 0 RL / IM
IPV: POLIOVAX POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD CONNAUGHT LTD. M0359 / 0 LL / IM

Administered by: Private      Purchased by: Unknown Public
Symptoms: Unevaluable event, REACT UNEVAL

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-01-11
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': NONE (blank)

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


Changed on 5/14/2017

VAERS ID: 106325 Before After
VAERS Form:
Age:0.2
Sex:Female
Location:Missouri
Vaccinated:1998-01-09
Onset:1998-01-11
Submitted:1998-01-12
Entered:1998-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 7H81507 / 0 LL / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 7D91713 / 0 RL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. M0359 / 0 LL / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-01-11
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE 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;


Changed on 9/14/2017

VAERS ID: 106325 Before After
VAERS Form:(blank) 1
Age:0.2
Sex:Female
Location:Missouri
Vaccinated:1998-01-09
Onset:1998-01-11
Submitted:1998-01-12
Entered:1998-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 7H81507 / 0 1 LL / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 7D91713 / 0 1 RL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. M0359 / 0 1 LL / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-01-11
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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;


Changed on 2/14/2018

VAERS ID: 106325 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:Missouri
Vaccinated:1998-01-09
Onset:1998-01-11
Submitted:1998-01-12
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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-01-11
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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;


Changed on 6/14/2018

VAERS ID: 106325 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:Missouri
Vaccinated:1998-01-09
Onset:1998-01-11
Submitted:1998-01-12
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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-01-11
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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;


Changed on 8/14/2018

VAERS ID: 106325 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:Missouri
Vaccinated:1998-01-09
Onset:1998-01-11
Submitted:1998-01-12
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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-01-11
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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;


Changed on 9/14/2018

VAERS ID: 106325 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:Missouri
Vaccinated:1998-01-09
Onset:1998-01-11
Submitted:1998-01-12
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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-01-11
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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;


Changed on 10/14/2018

VAERS ID: 106325 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:Missouri
Vaccinated:1998-01-09
Onset:1998-01-11
Submitted:1998-01-12
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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-01-11
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=106325&WAYBACKHISTORY=ON


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