National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 112251

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 112251
VAERS Form:
Age:0.2
Sex:Female
Location:Michigan
Vaccinated:1998-05-05
Onset:1998-05-06
Submitted:1998-06-23
Entered:1998-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: ACEL-IMUNE / LEDERLE 420629 / 0 LL / IM
HIBV: HIBTITER / LEDERLE(PRAXIS) 45190 / 0 RL / IM
IPV: POLIOVAX / CONNAUGHT LTD M0212 / 0 RL / SC

Administered by: Private      Purchased by: Unknown
Symptoms: SIDS, CYANOSIS, APNEA

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-05-06
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: Dimetapp;pt recv HBV 22MAR98;
Current Illness: Trismy 5, nasal congestion
Preexisting Conditions: Trisomy 5;
Allergies:
Diagnostic Lab Data: unk
CDC 'Split Type':

Write-up: pt reported by mom to have turned blue in car seat p/coming from hosp visit;911 called CPR done pt was taken to hosp;


Changed on 12/8/2009

VAERS ID: 112251 Before After
VAERS Form:
Age:0.2
Sex:Female
Location:Michigan
Vaccinated:1998-05-05
Onset:1998-05-06
Submitted:1998-06-23
Entered:1998-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: ACEL-IMUNE DTAP (ACEL-IMUNE) / LEDERLE LEDERLE LABORATORIES 420629 / 0 LL / IM
HIBV: HIBTITER HIB (HIBTITER) / LEDERLE(PRAXIS) LEDERLE LABORATORIES 45190 / 0 RL / IM
IPV: POLIOVAX POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD CONNAUGHT LTD. M0212 / 0 RL / SC

Administered by: Private Unknown      Purchased by: Unknown
Symptoms: Apnoea, Cyanosis, SIDS, Sudden infant death syndrome, CYANOSIS, APNEA

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-05-06
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: Dimetapp;pt recv HBV 22MAR98;
Current Illness: Trismy 5, nasal congestion
Preexisting Conditions: Trisomy 5;
Allergies:
Diagnostic Lab Data: unk
CDC 'Split Type':

Write-up: pt reported by mom to have turned blue in car seat p/coming from hosp visit;911 called CPR done pt was taken to hosp;


Changed on 5/14/2017

VAERS ID: 112251 Before After
VAERS Form:
Age:0.2
Sex:Female
Location:Michigan
Vaccinated:1998-05-05
Onset:1998-05-06
Submitted:1998-06-23
Entered:1998-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (ACEL-IMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 420629 / 0 LL / IM
HIBV: HIB (HIBTITER) / LEDERLE LABORATORIES PFIZER/WYETH 45190 / 0 RL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. M0212 / 0 RL / SC

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-05-06
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: Dimetapp;pt recv HBV 22MAR98;
Current Illness: Trismy 5, nasal congestion
Preexisting Conditions: Trisomy 5;
Allergies:
Diagnostic Lab Data: unk
CDC 'Split Type':

Write-up: pt reported by mom to have turned blue in car seat p/coming from hosp visit;911 called CPR done pt was taken to hosp;


Changed on 9/14/2017

VAERS ID: 112251 Before After
VAERS Form:(blank) 1
Age:0.2
Sex:Female
Location:Michigan
Vaccinated:1998-05-05
Onset:1998-05-06
Submitted:1998-06-23
Entered:1998-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (ACEL-IMUNE) / PFIZER/WYETH 420629 / 0 1 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH 45190 / 0 1 RL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. M0212 / 0 1 RL / SC

Administered by: Private      Purchased by: Private
Symptoms: Apnoea, Cyanosis, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-05-06
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: Dimetapp;pt recv HBV 22MAR98;
Current Illness: Trismy 5, nasal congestion
Preexisting Conditions: Trisomy 5;
Allergies:
Diagnostic Lab Data: unk
CDC 'Split Type':

Write-up: pt reported by mom to have turned blue in car seat p/coming from hosp visit;911 called CPR done pt was taken to hosp;


Changed on 2/14/2018

VAERS ID: 112251 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:Michigan
Vaccinated:1998-05-05
Onset:1998-05-06
Submitted:1998-06-23
Entered:1998-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (ACEL-IMUNE) / PFIZER/WYETH 420629 / 1 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH 45190 / 1 RL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. M0212 / 1 RL / SC

Administered by: Private      Purchased by: Private
Symptoms: Apnoea, Cyanosis, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-05-06
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: Dimetapp;pt recv HBV 22MAR98;
Current Illness: Trismy 5, nasal congestion
Preexisting Conditions: Trisomy 5;
Allergies:
Diagnostic Lab Data: unk
CDC 'Split Type':

Write-up: pt reported by mom to have turned blue in car seat p/coming from hosp visit;911 called CPR done pt was taken to hosp;


Changed on 6/14/2018

VAERS ID: 112251 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:Michigan
Vaccinated:1998-05-05
Onset:1998-05-06
Submitted:1998-06-23
Entered:1998-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (ACEL-IMUNE) / PFIZER/WYETH 420629 / 1 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH 45190 / 1 RL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. M0212 / 1 RL / SC

Administered by: Private      Purchased by: Private
Symptoms: Apnoea, Cyanosis, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-05-06
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: Dimetapp;pt recv HBV 22MAR98;
Current Illness: Trismy 5, nasal congestion
Preexisting Conditions: Trisomy 5;
Allergies:
Diagnostic Lab Data: unk
CDC 'Split Type':

Write-up: pt reported by mom to have turned blue in car seat p/coming from hosp visit;911 called CPR done pt was taken to hosp;


Changed on 8/14/2018

VAERS ID: 112251 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:Michigan
Vaccinated:1998-05-05
Onset:1998-05-06
Submitted:1998-06-23
Entered:1998-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (ACEL-IMUNE) / PFIZER/WYETH 420629 / 1 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH 45190 / 1 RL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. M0212 / 1 RL / SC

Administered by: Private      Purchased by: Private
Symptoms: Apnoea, Cyanosis, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-05-06
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: Dimetapp;pt recv HBV 22MAR98;
Current Illness: Trismy 5, nasal congestion
Preexisting Conditions: Trisomy 5;
Allergies:
Diagnostic Lab Data: unk
CDC 'Split Type':

Write-up: pt reported by mom to have turned blue in car seat p/coming from hosp visit;911 called CPR done pt was taken to hosp;


Changed on 9/14/2018

VAERS ID: 112251 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:Michigan
Vaccinated:1998-05-05
Onset:1998-05-06
Submitted:1998-06-23
Entered:1998-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (ACEL-IMUNE) / PFIZER/WYETH 420629 / 1 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH 45190 / 1 RL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. M0212 / 1 RL / SC

Administered by: Private      Purchased by: Private
Symptoms: Apnoea, Cyanosis, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-05-06
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: Dimetapp;pt recv HBV 22MAR98;
Current Illness: Trismy 5, nasal congestion
Preexisting Conditions: Trisomy 5;
Allergies:
Diagnostic Lab Data: unk
CDC 'Split Type':

Write-up: pt reported by mom to have turned blue in car seat p/coming from hosp visit;911 called CPR done pt was taken to hosp;


Changed on 10/14/2018

VAERS ID: 112251 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:Michigan
Vaccinated:1998-05-05
Onset:1998-05-06
Submitted:1998-06-23
Entered:1998-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (ACEL-IMUNE) / PFIZER/WYETH 420629 / 1 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH 45190 / 1 RL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. M0212 / 1 RL / SC

Administered by: Private      Purchased by: Private
Symptoms: Apnoea, Cyanosis, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-05-06
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: Dimetapp;pt recv HBV 22MAR98;
Current Illness: Trismy 5, nasal congestion
Preexisting Conditions: Trisomy 5;
Allergies:
Diagnostic Lab Data: unk
CDC 'Split Type':

Write-up: pt reported by mom to have turned blue in car seat p/coming from hosp visit;911 called CPR done pt was taken to hosp;

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=112251&WAYBACKHISTORY=ON


Copyright © 2020 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166