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This is VAERS ID 110683

Case Details

VAERS ID: 110683 (history)  
Form: Version 1.0  
Age: 0.1  
Sex: Male  
Location: North Carolina  
Vaccinated:1998-04-16
Onset:1998-04-22
   Days after vaccination:6
Submitted: 1998-04-27
   Days after onset:5
Entered: 1998-05-08
   Days after submission:11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 2375A2 / 2 LA / IM

Administered by: Public       Purchased by: Public
Symptoms: Hepatitis, Hypokinesia, Jaundice, Stupor
SMQs:, Cholestasis and jaundice of hepatic origin (narrow), Hepatitis, non-infectious (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Biliary system related investigations, signs and symptoms (narrow), Biliary tract disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1998-04-22
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: jaundiced;
Preexisting Conditions: 35wk gestation, unifocal PVC on night of birth, bradycardia episodes, poor feeding;large spits & wt loss
Allergies:
Diagnostic Lab Data: autopsy
CDC Split Type: NC98011

Write-up: mom called clinic p/early lunch & told nurse that hot up this AM 22APR98 & pt was not moving;mom attempted rescue breathing w/no response, pt transported to hosp & is now dead;


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