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This is VAERS ID 112192

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 112192
VAERS Form:
Age:0.2
Sex:Male
Location:Mississippi
Vaccinated:1998-03-12
Onset:1998-03-14
Submitted:1998-05-01
Entered:1998-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: TRIPEDIA / CONNAUGHT LABS 7B91821 / 0 LL / -
HBHEPB: COMVAX / MSD 0571E / 0 RL / -
IPV: POLIOVAX / CONNAUGHT LTD M1070 / 0 RL / -

Administered by: Public      Purchased by: Unknown
Symptoms: SIDS, STUPOR

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-03-14
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: unk
Current Illness: NONE
Preexisting Conditions: NONE-rash on face-oily-probably secondary to immature sweat gland
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: mom states tried to wake pt 14MAR98 but pt did not wake up;pt okay when went to sleep;


Changed on 12/8/2009

VAERS ID: 112192 Before After
VAERS Form:
Age:0.2
Sex:Male
Location:Mississippi
Vaccinated:1998-03-12
Onset:1998-03-14
Submitted:1998-05-01
Entered:1998-06-29 1998-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: TRIPEDIA DTAP (TRIPEDIA) / CONNAUGHT LABS CONNAUGHT LABORATORIES 7B91821 / 0 LL / -
HBHEPB: COMVAX HIB + HEP B (COMVAX) / MSD MERCK & CO. INC. 0571E / 0 RL / -
IPV: POLIOVAX POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD CONNAUGHT LTD. M1070 / 0 RL / -

Administered by: Public Unknown      Purchased by: Unknown
Symptoms: SIDS, Stupor, Sudden infant death syndrome, STUPOR

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-03-14
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: unk
Current Illness: NONE
Preexisting Conditions: NONE-rash on face-oily-probably secondary to immature sweat gland
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': (blank) MS98008

Write-up: mom states tried to wake pt 14MAR98 but pt did not wake up;pt okay when went to sleep;


Changed on 5/14/2017

VAERS ID: 112192 Before After
VAERS Form:
Age:0.2
Sex:Male
Location:Mississippi
Vaccinated:1998-03-12
Onset:1998-03-14
Submitted:1998-05-01
Entered:1998-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 7B91821 / 0 LL / -
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 0571E / 0 RL / -
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. M1070 / 0 RL / -

Administered by: Unknown Public      Purchased by: Unknown Public
Symptoms: Stupor, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-03-14
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: unk
Current Illness: NONE
Preexisting Conditions: NONE-rash on face-oily-probably secondary to immature sweat gland
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': MS98008

Write-up: mom states tried to wake pt 14MAR98 but pt did not wake up;pt okay when went to sleep;


Changed on 9/14/2017

VAERS ID: 112192 Before After
VAERS Form:(blank) 1
Age:0.2
Sex:Male
Location:Mississippi
Vaccinated:1998-03-12
Onset:1998-03-14
Submitted:1998-05-01
Entered:1998-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 7B91821 / 0 1 LL / -
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 0571E / 0 1 RL / -
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. M1070 / 0 1 RL / -

Administered by: Public      Purchased by: Public
Symptoms: Stupor, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-03-14
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: unk
Current Illness: NONE
Preexisting Conditions: NONE-rash on face-oily-probably secondary to immature sweat gland
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': MS98008

Write-up: mom states tried to wake pt 14MAR98 but pt did not wake up;pt okay when went to sleep;


Changed on 2/14/2018

VAERS ID: 112192 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Mississippi
Vaccinated:1998-03-12
Onset:1998-03-14
Submitted:1998-05-01
Entered:1998-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 7B91821 / 1 LL / -
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 0571E / 1 RL / -
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. M1070 / 1 RL / -

Administered by: Public      Purchased by: Public
Symptoms: Stupor, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-03-14
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: unk
Current Illness: NONE
Preexisting Conditions: NONE-rash on face-oily-probably secondary to immature sweat gland
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': MS98008

Write-up: mom states tried to wake pt 14MAR98 but pt did not wake up;pt okay when went to sleep;


Changed on 6/14/2018

VAERS ID: 112192 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Mississippi
Vaccinated:1998-03-12
Onset:1998-03-14
Submitted:1998-05-01
Entered:1998-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 7B91821 / 1 LL / -
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 0571E / 1 RL / -
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. M1070 / 1 RL / -

Administered by: Public      Purchased by: Public
Symptoms: Stupor, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-03-14
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: unk
Current Illness: NONE
Preexisting Conditions: NONE-rash on face-oily-probably secondary to immature sweat gland
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': MS98008

Write-up: mom states tried to wake pt 14MAR98 but pt did not wake up;pt okay when went to sleep;


Changed on 8/14/2018

VAERS ID: 112192 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Mississippi
Vaccinated:1998-03-12
Onset:1998-03-14
Submitted:1998-05-01
Entered:1998-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 7B91821 / 1 LL / -
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 0571E / 1 RL / -
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. M1070 / 1 RL / -

Administered by: Public      Purchased by: Public
Symptoms: Stupor, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-03-14
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: unk
Current Illness: NONE
Preexisting Conditions: NONE-rash on face-oily-probably secondary to immature sweat gland
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': MS98008

Write-up: mom states tried to wake pt 14MAR98 but pt did not wake up;pt okay when went to sleep;


Changed on 9/14/2018

VAERS ID: 112192 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Mississippi
Vaccinated:1998-03-12
Onset:1998-03-14
Submitted:1998-05-01
Entered:1998-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 7B91821 / 1 LL / -
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 0571E / 1 RL / -
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. M1070 / 1 RL / -

Administered by: Public      Purchased by: Public
Symptoms: Stupor, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-03-14
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: unk
Current Illness: NONE
Preexisting Conditions: NONE-rash on face-oily-probably secondary to immature sweat gland
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': MS98008

Write-up: mom states tried to wake pt 14MAR98 but pt did not wake up;pt okay when went to sleep;


Changed on 10/14/2018

VAERS ID: 112192 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Mississippi
Vaccinated:1998-03-12
Onset:1998-03-14
Submitted:1998-05-01
Entered:1998-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 7B91821 / 1 LL / -
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 0571E / 1 RL / -
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. M1070 / 1 RL / -

Administered by: Public      Purchased by: Public
Symptoms: Stupor, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-03-14
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: unk
Current Illness: NONE
Preexisting Conditions: NONE-rash on face-oily-probably secondary to immature sweat gland
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': MS98008

Write-up: mom states tried to wake pt 14MAR98 but pt did not wake up;pt okay when went to sleep;

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=112192&WAYBACKHISTORY=ON


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