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This is VAERS ID 108795

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 108795
VAERS Form:
Age:0.0
Sex:Female
Location:New Hampshire
Vaccinated:1996-04-13
Onset:1996-04-28
Submitted:1998-03-19
Entered:1998-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: RECOMBIVAX HB / MSD 1163A / 0 RL / -

Administered by: Private      Purchased by: Unknown
Symptoms: SIDS, ANOMALY CONGEN, CYST, SLEEP PAR BED

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1996-04-28
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:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: SIDS


Changed on 12/8/2009

VAERS ID: 108795 Before After
VAERS Form:
Age:0.0
Sex:Female
Location:New Hampshire
Vaccinated:1996-04-13
Onset:1996-04-28
Submitted:1998-03-19
Entered:1998-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: RECOMBIVAX HB HEP B (RECOMBIVAX HB) / MSD MERCK & CO. INC. 1163A / 0 RL / -

Administered by: Private      Purchased by: Unknown Public
Symptoms: Congenital anomaly, Cyst, SIDS, Sudden infant death syndrome, Unevaluable event, ANOMALY CONGEN, CYST, SLEEP PAR BED

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1996-04-28
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:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) NH9634

Write-up: SIDS


Changed on 5/14/2017

VAERS ID: 108795 Before After
VAERS Form:
Age:0.0
Sex:Female
Location:New Hampshire
Vaccinated:1996-04-13
Onset:1996-04-28
Submitted:1998-03-19
Entered:1998-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1163A / 0 RL / -

Administered by: Private      Purchased by: Public
Symptoms: Congenital anomaly, Cyst, Sudden infant death syndrome, Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1996-04-28
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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NH9634

Write-up: SIDS


Changed on 9/14/2017

VAERS ID: 108795 Before After
VAERS Form:(blank) 1
Age:0.0
Sex:Female
Location:New Hampshire
Vaccinated:1996-04-13
Onset:1996-04-28
Submitted:1998-03-19
Entered:1998-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1163A / 0 1 RL / -

Administered by: Private      Purchased by: Public
Symptoms: Congenital anomaly, Cyst, Sudden infant death syndrome, Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1996-04-28
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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NH9634

Write-up: SIDS


Changed on 2/14/2018

VAERS ID: 108795 Before After
VAERS Form:1
Age:0.0
Sex:Female
Location:New Hampshire
Vaccinated:1996-04-13
Onset:1996-04-28
Submitted:1998-03-19
Entered:1998-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1163A / 1 RL / -

Administered by: Private      Purchased by: Public
Symptoms: Congenital anomaly, Cyst, Sudden infant death syndrome, Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1996-04-28
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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NH9634

Write-up: SIDS


Changed on 6/14/2018

VAERS ID: 108795 Before After
VAERS Form:1
Age:0.0
Sex:Female
Location:New Hampshire
Vaccinated:1996-04-13
Onset:1996-04-28
Submitted:1998-03-19
Entered:1998-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1163A / 1 RL / -

Administered by: Private      Purchased by: Public
Symptoms: Congenital anomaly, Cyst, Sudden infant death syndrome, Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1996-04-28
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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NH9634

Write-up: SIDS


Changed on 8/14/2018

VAERS ID: 108795 Before After
VAERS Form:1
Age:0.0
Sex:Female
Location:New Hampshire
Vaccinated:1996-04-13
Onset:1996-04-28
Submitted:1998-03-19
Entered:1998-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1163A / 1 RL / -

Administered by: Private      Purchased by: Public
Symptoms: Congenital anomaly, Cyst, Sudden infant death syndrome, Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1996-04-28
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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NH9634

Write-up: SIDS


Changed on 9/14/2018

VAERS ID: 108795 Before After
VAERS Form:1
Age:0.0
Sex:Female
Location:New Hampshire
Vaccinated:1996-04-13
Onset:1996-04-28
Submitted:1998-03-19
Entered:1998-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1163A / 1 RL / -

Administered by: Private      Purchased by: Public
Symptoms: Congenital anomaly, Cyst, Sudden infant death syndrome, Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1996-04-28
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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NH9634

Write-up: SIDS


Changed on 10/14/2018

VAERS ID: 108795 Before After
VAERS Form:1
Age:0.0
Sex:Female
Location:New Hampshire
Vaccinated:1996-04-13
Onset:1996-04-28
Submitted:1998-03-19
Entered:1998-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1163A / 1 RL / -

Administered by: Private      Purchased by: Public
Symptoms: Congenital anomaly, Cyst, Sudden infant death syndrome, Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1996-04-28
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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NH9634

Write-up: SIDS


Changed on 7/14/2019

VAERS ID: 108795 Before After
VAERS Form:1
Age:0.0 (blank)
Sex:Female
Location:New Hampshire
Vaccinated:1996-04-13
Onset:1996-04-28
Submitted:1998-03-19
Entered:1998-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1163A / 1 RL / -

Administered by: Private      Purchased by: Public
Symptoms: Congenital anomaly, Cyst, Sudden infant death syndrome, Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1996-04-28
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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NH9634

Write-up: SIDS

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