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This is VAERS ID 114427

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 114427
VAERS Form:
Age:0.1
Sex:Female
Location:New York
Vaccinated:1998-09-15
Onset:1998-09-16
Submitted:1998-09-16
Entered:1998-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: RECOMBIVAX HB / MSD 0984H / 1 RL / IM

Administered by: Private      Purchased by: Unknown
Symptoms: SIDS

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-09-16
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:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: autopsy report pending
CDC 'Split Type':

Write-up: pt recv vax 15SEP98 pt died of presumptive sudden infant death synd following morning 16SEP98;


Changed on 12/8/2009

VAERS ID: 114427 Before After
VAERS Form:
Age:0.1
Sex:Female
Location:New York
Vaccinated:1998-09-15
Onset:1998-09-16
Submitted:1998-09-16
Entered:1998-09-29 1998-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: RECOMBIVAX HB HEP B (RECOMBIVAX HB) / MSD MERCK & CO. INC. 0984H / 1 RL / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-09-16
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:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: autopsy report pending
CDC 'Split Type':

Write-up: pt recv vax 15SEP98 pt died of presumptive sudden infant death synd following morning 16SEP98;


Changed on 5/14/2017

VAERS ID: 114427 Before After
VAERS Form:
Age:0.1
Sex:Female
Location:New York
Vaccinated:1998-09-15
Onset:1998-09-16
Submitted:1998-09-16
Entered:1998-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0984H / 1 RL / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-09-16
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:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: autopsy report pending
CDC 'Split Type':

Write-up: pt recv vax 15SEP98 pt died of presumptive sudden infant death synd following morning 16SEP98;


Changed on 9/14/2017

VAERS ID: 114427 Before After
VAERS Form:(blank) 1
Age:0.1
Sex:Female
Location:New York
Vaccinated:1998-09-15
Onset:1998-09-16
Submitted:1998-09-16
Entered:1998-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0984H / 1 2 RL / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-09-16
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:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: autopsy report pending
CDC 'Split Type':

Write-up: pt recv vax 15SEP98 pt died of presumptive sudden infant death synd following morning 16SEP98;


Changed on 2/14/2018

VAERS ID: 114427 Before After
VAERS Form:1
Age:0.1
Sex:Female
Location:New York
Vaccinated:1998-09-15
Onset:1998-09-16
Submitted:1998-09-16
Entered:1998-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0984H / 2 RL / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-09-16
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:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: autopsy report pending
CDC 'Split Type':

Write-up: pt recv vax 15SEP98 pt died of presumptive sudden infant death synd following morning 16SEP98;


Changed on 6/14/2018

VAERS ID: 114427 Before After
VAERS Form:1
Age:0.1
Sex:Female
Location:New York
Vaccinated:1998-09-15
Onset:1998-09-16
Submitted:1998-09-16
Entered:1998-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0984H / 2 RL / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-09-16
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:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: autopsy report pending
CDC 'Split Type':

Write-up: pt recv vax 15SEP98 pt died of presumptive sudden infant death synd following morning 16SEP98;


Changed on 8/14/2018

VAERS ID: 114427 Before After
VAERS Form:1
Age:0.1
Sex:Female
Location:New York
Vaccinated:1998-09-15
Onset:1998-09-16
Submitted:1998-09-16
Entered:1998-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0984H / 2 RL / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-09-16
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:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: autopsy report pending
CDC 'Split Type':

Write-up: pt recv vax 15SEP98 pt died of presumptive sudden infant death synd following morning 16SEP98;


Changed on 9/14/2018

VAERS ID: 114427 Before After
VAERS Form:1
Age:0.1
Sex:Female
Location:New York
Vaccinated:1998-09-15
Onset:1998-09-16
Submitted:1998-09-16
Entered:1998-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0984H / 2 RL / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-09-16
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:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: autopsy report pending
CDC 'Split Type':

Write-up: pt recv vax 15SEP98 pt died of presumptive sudden infant death synd following morning 16SEP98;


Changed on 10/14/2018

VAERS ID: 114427 Before After
VAERS Form:1
Age:0.1
Sex:Female
Location:New York
Vaccinated:1998-09-15
Onset:1998-09-16
Submitted:1998-09-16
Entered:1998-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0984H / 2 RL / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-09-16
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:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: autopsy report pending
CDC 'Split Type':

Write-up: pt recv vax 15SEP98 pt died of presumptive sudden infant death synd following morning 16SEP98;

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=114427&WAYBACKHISTORY=ON


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