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This is VAERS ID 113915

Case Details

VAERS ID: 113915 (history)  
Form: Version 1.0  
Age: 0.1  
Sex: Female  
Location: Minnesota  
Vaccinated:1998-09-03
Onset:1998-09-03
   Days after vaccination:0
Submitted: 1998-09-03
   Days after onset:0
Entered: 1998-09-08
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 2705A2 / 1 LL / IM

Administered by: Private       Purchased by: Private
Symptoms: Cardiac failure, Cardiomegaly, Congenital anomaly
SMQs:, Cardiac failure (narrow), Congenital, familial and genetic disorders (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1998-09-03
   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:
CDC Split Type:

Write-up: preliminary rpeort baby died in car ride home, no preceding sx, signs;EMS called @ 942AM autopsy currently being done;


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