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This is VAERS ID 150618

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 150618
VAERS Form:
Age:0.6
Sex:Female
Location:Arizona
Vaccinated:2000-03-15
Onset:0000-00-00
Submitted:2000-03-29
Entered:2000-04-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: TRIPEDIA / CONNAUGHT LABS 7316BB / 2 LL / IM
HIBV: HIBTITER / LEDERLE(PRAXIS) 530453A / 2 LL / IM
IPV: POLIOVAX / CONNAUGHT LTD R0444 / 2 - / SC

Administered by: Private      Purchased by: Unknown
Symptoms: REACT UNEVAL

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-03-27
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: Exposure to Hep B at birth
Allergies:
Diagnostic Lab Data: autopsy-pending
CDC 'Split Type':

Write-up: No adverse reaction to immunizations. Unknown states ""as far as we know, pt did not have reaction (fever etc).


Changed on 12/30/2006

VAERS ID: 150618 Before After
VAERS Form:
Age:0.6
Sex:Female
Location:Arizona
Vaccinated:2000-03-15
Onset:0000-00-00
Submitted:2000-03-29
Entered:2000-04-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: TRIPEDIA / CONNAUGHT LABS 7316BB / 2 LL / IM
HIBV: HIBTITER / LEDERLE(PRAXIS) 530453A / 2 LL / IM
IPV: POLIOVAX / CONNAUGHT LTD R0444 / 2 - / SC

Administered by: Private      Purchased by: Unknown
Symptoms: REACT UNEVAL

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-03-27
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: Exposure to Hep B at birth
Allergies:
Diagnostic Lab Data: autopsy-pending
CDC 'Split Type':

Write-up: No adverse reaction to immunizations. Unknown states ""as /"as far as we know, pt did not have reaction (fever etc).


Changed on 12/8/2009

VAERS ID: 150618 Before After
VAERS Form:
Age:0.6
Sex:Female
Location:Arizona
Vaccinated:2000-03-15
Onset:0000-00-00
Submitted:2000-03-29
Entered:2000-04-03 2000-03-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: TRIPEDIA DTAP (TRIPEDIA) / CONNAUGHT LABS CONNAUGHT LABORATORIES 7316BB / 2 LL / IM
HIBV: HIBTITER HIB (HIBTITER) / LEDERLE(PRAXIS) LEDERLE PRAXSIS 530453A / 2 LL / IM
IPV: POLIOVAX POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD CONNAUGHT LTD. R0444 / 2 - / SC

Administered by: Private      Purchased by: Unknown Other
Symptoms: Coma, Pneumonia, Pulmonary congestion, Pulmonary oedema, Unevaluable event, REACT UNEVAL

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-03-27
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: Exposure to Hep B at birth
Allergies:
Diagnostic Lab Data: autopsy-pending
CDC 'Split Type':

Write-up: No adverse reaction to immunizations. Unknown states /"as "as far as we know, pt did not have reaction (fever etc). Infant given a bottle and put down for nap. Later the babysitter found the baby unresponsive. Autospy states cause of death as pneumonia. Autopsy also shows pulmonary edema and congestion. .


Changed on 5/14/2017

VAERS ID: 150618 Before After
VAERS Form:
Age:0.6
Sex:Female
Location:Arizona
Vaccinated:2000-03-15
Onset:0000-00-00
Submitted:2000-03-29
Entered:2000-03-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 7316BB / 2 LL / IM
HIBV: HIB (HIBTITER) / LEDERLE PRAXSIS PFIZER/WYETH 530453A / 2 LL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. R0444 / 2 - / SC

Administered by: Private      Purchased by: Other
Symptoms: Coma, Pneumonia, Pulmonary congestion, Pulmonary oedema, Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-03-27
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: Exposure to Hep B at birth
Allergies:
Diagnostic Lab Data: autopsy-pending
CDC 'Split Type':

Write-up: No adverse reaction to immunizations. Unknown states "as far as we know, pt did not have reaction (fever etc). Infant given a bottle and put down for nap. Later the babysitter found the baby unresponsive. Autospy states cause of death as pneumonia. Autopsy also shows pulmonary edema and congestion. .


Changed on 9/14/2017

VAERS ID: 150618 Before After
VAERS Form:(blank) 1
Age:0.6
Sex:Female
Location:Arizona
Vaccinated:2000-03-15
Onset:0000-00-00
Submitted:2000-03-29
Entered:2000-03-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 7316BB / 2 3 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH 530453A / 2 3 LL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. R0444 / 2 3 - / SC

Administered by: Private      Purchased by: Other
Symptoms: Coma, Pneumonia, Pulmonary congestion, Pulmonary oedema, Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-03-27
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: Exposure to Hep B at birth
Allergies:
Diagnostic Lab Data: autopsy-pending
CDC 'Split Type':

Write-up: No adverse reaction to immunizations. Unknown states "as far as we know, pt did not have reaction (fever etc). Infant given a bottle and put down for nap. Later the babysitter found the baby unresponsive. Autospy states cause of death as pneumonia. Autopsy also shows pulmonary edema and congestion.


Changed on 2/14/2018

VAERS ID: 150618 Before After
VAERS Form:1
Age:0.6
Sex:Female
Location:Arizona
Vaccinated:2000-03-15
Onset:0000-00-00
Submitted:2000-03-29
Entered:2000-03-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 7316BB / 3 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH 530453A / 3 LL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. R0444 / 3 - / SC

Administered by: Private      Purchased by: Other
Symptoms: Coma, Pneumonia, Pulmonary congestion, Pulmonary oedema, Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-03-27
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: Exposure to Hep B at birth
Allergies:
Diagnostic Lab Data: autopsy-pending
CDC 'Split Type':

Write-up: No adverse reaction to immunizations. Unknown states "as far as we know, pt did not have reaction (fever etc). Infant given a bottle and put down for nap. Later the babysitter found the baby unresponsive. Autospy states cause of death as pneumonia. Autopsy also shows pulmonary edema and congestion.


Changed on 6/14/2018

VAERS ID: 150618 Before After
VAERS Form:1
Age:0.6
Sex:Female
Location:Arizona
Vaccinated:2000-03-15
Onset:0000-00-00
Submitted:2000-03-29
Entered:2000-03-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 7316BB / 3 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH 530453A / 3 LL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. R0444 / 3 - / SC

Administered by: Private      Purchased by: Other
Symptoms: Coma, Pneumonia, Pulmonary congestion, Pulmonary oedema, Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-03-27
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: Exposure to Hep B at birth
Allergies:
Diagnostic Lab Data: autopsy-pending
CDC 'Split Type':

Write-up: No adverse reaction to immunizations. Unknown states "as far as we know, pt did not have reaction (fever etc). Infant given a bottle and put down for nap. Later the babysitter found the baby unresponsive. Autospy states cause of death as pneumonia. Autopsy also shows pulmonary edema and congestion.


Changed on 8/14/2018

VAERS ID: 150618 Before After
VAERS Form:1
Age:0.6
Sex:Female
Location:Arizona
Vaccinated:2000-03-15
Onset:0000-00-00
Submitted:2000-03-29
Entered:2000-03-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 7316BB / 3 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH 530453A / 3 LL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. R0444 / 3 - / SC

Administered by: Private      Purchased by: Other
Symptoms: Coma, Pneumonia, Pulmonary congestion, Pulmonary oedema, Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-03-27
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: Exposure to Hep B at birth
Allergies:
Diagnostic Lab Data: autopsy-pending
CDC 'Split Type':

Write-up: No adverse reaction to immunizations. Unknown states "as far as we know, pt did not have reaction (fever etc). Infant given a bottle and put down for nap. Later the babysitter found the baby unresponsive. Autospy states cause of death as pneumonia. Autopsy also shows pulmonary edema and congestion.


Changed on 9/14/2018

VAERS ID: 150618 Before After
VAERS Form:1
Age:0.6
Sex:Female
Location:Arizona
Vaccinated:2000-03-15
Onset:0000-00-00
Submitted:2000-03-29
Entered:2000-03-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 7316BB / 3 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH 530453A / 3 LL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. R0444 / 3 - / SC

Administered by: Private      Purchased by: Other
Symptoms: Coma, Pneumonia, Pulmonary congestion, Pulmonary oedema, Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-03-27
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: Exposure to Hep B at birth
Allergies:
Diagnostic Lab Data: autopsy-pending
CDC 'Split Type':

Write-up: No adverse reaction to immunizations. Unknown states "as far as we know, pt did not have reaction (fever etc). Infant given a bottle and put down for nap. Later the babysitter found the baby unresponsive. Autospy states cause of death as pneumonia. Autopsy also shows pulmonary edema and congestion.


Changed on 10/14/2018

VAERS ID: 150618 Before After
VAERS Form:1
Age:0.6
Sex:Female
Location:Arizona
Vaccinated:2000-03-15
Onset:0000-00-00
Submitted:2000-03-29
Entered:2000-03-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 7316BB / 3 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH 530453A / 3 LL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. R0444 / 3 - / SC

Administered by: Private      Purchased by: Other
Symptoms: Coma, Pneumonia, Pulmonary congestion, Pulmonary oedema, Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-03-27
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: Exposure to Hep B at birth
Allergies:
Diagnostic Lab Data: autopsy-pending
CDC 'Split Type':

Write-up: No adverse reaction to immunizations. Unknown states "as far as we know, pt did not have reaction (fever etc). Infant given a bottle and put down for nap. Later the babysitter found the baby unresponsive. Autospy states cause of death as pneumonia. Autopsy also shows pulmonary edema and congestion.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=150618&WAYBACKHISTORY=ON


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