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This is VAERS ID 112250

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 112250
VAERS Form:
Age:0.1
Sex:Female
Location:New York
Vaccinated:1998-06-15
Onset:1998-06-16
Submitted:1998-06-23
Entered:1998-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: ENGERIX-B / SMITHKLINE 2587A2 / 0 LL / -

Administered by: Private      Purchased by: Unknown
Symptoms: SIDS

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-06-16
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: NONE
Current Illness: NONE
Preexisting Conditions: well child
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': well child

Write-up: SIDS 16JUN98 <24hr p/vax;autopsy performed @ medical examiners p/transport from hosp;


Changed on 12/8/2009

VAERS ID: 112250 Before After
VAERS Form:
Age:0.1
Sex:Female
Location:New York
Vaccinated:1998-06-15
Onset:1998-06-16
Submitted:1998-06-23
Entered:1998-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: ENGERIX-B HEP B (ENGERIX-B) / SMITHKLINE SMITHKLINE BEECHAM 2587A2 / 0 LL / -

Administered by: Private      Purchased by: Unknown Private
Symptoms: SIDS, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-06-16
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: NONE
Current Illness: NONE
Preexisting Conditions: well child
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': well child (blank)

Write-up: SIDS 16JUN98 <24hr p/vax;autopsy performed @ medical examiners p/transport from hosp;


Changed on 5/14/2017

VAERS ID: 112250 Before After
VAERS Form:
Age:0.1
Sex:Female
Location:New York
Vaccinated:1998-06-15
Onset:1998-06-16
Submitted:1998-06-23
Entered:1998-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 2587A2 / 0 LL / -

Administered by: Private      Purchased by: Private
Symptoms: Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-06-16
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: NONE
Current Illness: NONE
Preexisting Conditions: well child
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: SIDS 16JUN98 <24hr p/vax;autopsy performed @ medical examiners p/transport from hosp;


Changed on 9/14/2017

VAERS ID: 112250 Before After
VAERS Form:(blank) 1
Age:0.1
Sex:Female
Location:New York
Vaccinated:1998-06-15
Onset:1998-06-16
Submitted:1998-06-23
Entered:1998-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 2587A2 / 0 1 LL / -

Administered by: Private      Purchased by: Private
Symptoms: Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-06-16
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: NONE
Current Illness: NONE
Preexisting Conditions: well child
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: SIDS 16JUN98 <24hr p/vax;autopsy performed @ medical examiners p/transport from hosp;


Changed on 2/14/2018

VAERS ID: 112250 Before After
VAERS Form:1
Age:0.1
Sex:Female
Location:New York
Vaccinated:1998-06-15
Onset:1998-06-16
Submitted:1998-06-23
Entered:1998-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 2587A2 / 1 LL / -

Administered by: Private      Purchased by: Private
Symptoms: Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-06-16
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: NONE
Current Illness: NONE
Preexisting Conditions: well child
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: SIDS 16JUN98 <24hr p/vax;autopsy performed @ medical examiners p/transport from hosp;


Changed on 6/14/2018

VAERS ID: 112250 Before After
VAERS Form:1
Age:0.1
Sex:Female
Location:New York
Vaccinated:1998-06-15
Onset:1998-06-16
Submitted:1998-06-23
Entered:1998-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 2587A2 / 1 LL / -

Administered by: Private      Purchased by: Private
Symptoms: Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-06-16
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: NONE
Current Illness: NONE
Preexisting Conditions: well child
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: SIDS 16JUN98 <24hr p/vax;autopsy performed @ medical examiners p/transport from hosp;


Changed on 8/14/2018

VAERS ID: 112250 Before After
VAERS Form:1
Age:0.1
Sex:Female
Location:New York
Vaccinated:1998-06-15
Onset:1998-06-16
Submitted:1998-06-23
Entered:1998-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 2587A2 / 1 LL / -

Administered by: Private      Purchased by: Private
Symptoms: Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-06-16
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: NONE
Current Illness: NONE
Preexisting Conditions: well child
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: SIDS 16JUN98 <24hr p/vax;autopsy performed @ medical examiners p/transport from hosp;


Changed on 9/14/2018

VAERS ID: 112250 Before After
VAERS Form:1
Age:0.1
Sex:Female
Location:New York
Vaccinated:1998-06-15
Onset:1998-06-16
Submitted:1998-06-23
Entered:1998-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 2587A2 / 1 LL / -

Administered by: Private      Purchased by: Private
Symptoms: Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-06-16
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: NONE
Current Illness: NONE
Preexisting Conditions: well child
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: SIDS 16JUN98 <24hr p/vax;autopsy performed @ medical examiners p/transport from hosp;


Changed on 10/14/2018

VAERS ID: 112250 Before After
VAERS Form:1
Age:0.1
Sex:Female
Location:New York
Vaccinated:1998-06-15
Onset:1998-06-16
Submitted:1998-06-23
Entered:1998-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 2587A2 / 1 LL / -

Administered by: Private      Purchased by: Private
Symptoms: Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-06-16
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: NONE
Current Illness: NONE
Preexisting Conditions: well child
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: SIDS 16JUN98 <24hr p/vax;autopsy performed @ medical examiners p/transport from hosp;

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