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This is VAERS ID 112335

Case Details

VAERS ID: 112335 (history)  
Form: Version 1.0  
Age: 38.0  
Sex: Male  
Location: Hawaii  
Vaccinated:1998-04-27
Onset:1998-05-04
   Days after vaccination:7
Submitted: 1998-06-25
   Days after onset:52
Entered: 1998-07-06
   Days after submission:11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0052H / 1 LA / SC

Administered by: Private       Purchased by: Private
Symptoms: Apnoea, Arteriosclerosis, Brain oedema, Cardiac arrest, Coronary artery disease, Myocardial ischaemia
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (narrow), Hyponatraemia/SIADH (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Other ischaemic heart disease (narrow), Respiratory failure (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1998-05-04
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: varicella IGG teston 25APR98 was negative;
CDC Split Type:

Write-up: pt exposed to chickenpox 12wk prior to first visit;varicella IGG test was negative 25APR98;pt recv vax 27APR98 no subsequent sx;pt was found lifeless on 4MAY98 while taking a nap;autopsy was performed;


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