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This is VAERS ID 113661

Case Details

VAERS ID: 113661 (history)  
Form: Version 1.0  
Age: 1.3  
Sex: Female  
Location: Unknown  
Vaccinated:1998-05-11
Onset:1998-05-16
   Days after vaccination:5
Submitted: 1998-08-24
   Days after onset:100
Entered: 1998-08-27
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Cardiovascular disorder, Condition aggravated, Hepatitis, Hypersensitivity, Hypertonia, Meningitis, Vomiting
SMQs:, Hepatitis, non-infectious (narrow), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypokalaemia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1998-05-16
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: No relevant data;~ ()~~~In patient
Other Medications: antimicrobial therapy
Current Illness:
Preexisting Conditions: otitis med;upper resp infect
Allergies:
Diagnostic Lab Data: autopsy eosinophils around cardiac vessles;autopsy no viral inclusions in liver;only frontal lobe specimen pos for wild type VZV on PCR analysis;heart & cerebellum high ELISA''s
CDC Split Type: WAES98070287

Write-up: 4 days post vax pt died;mom described child as fussy 15MAY98 w/n/v then becoming rigid in arms & legs;COD originally believe to be myocarditis now feel meningitis;sz, noted hepatitis w/multifocal inflam;allerg react;


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