National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 150931

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 150931
VAERS Form:
Age:0.2
Sex:Female
Location:Massachusetts
Vaccinated:2000-03-31
Onset:2000-04-01
Submitted:2000-04-04
Entered:2000-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: TRIPEDIA / CONNAUGHT LABS 40040CA / 0 LL / IM
HIBV: HIBTITER / LEDERLE(PRAXIS) 530453A / 0 RL / IM
IPV: POLIOVAX / CONNAUGHT LTD PO257 / 0 LL / IM

Administered by: Private      Purchased by: Unknown
Symptoms: APNEA

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-04-01
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
CDC 'Split Type':

Write-up: Pt was well and went to sleep at approximately 10:30 pm. Found at 6:00 am not breathing. Pt had been put to sleep on her side but was found on stomach.


Changed on 12/8/2009

VAERS ID: 150931 Before After
VAERS Form:
Age:0.2
Sex:Female
Location:Massachusetts
Vaccinated:2000-03-31
Onset:2000-04-01
Submitted:2000-04-04
Entered:2000-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: TRIPEDIA DTAP (TRIPEDIA) / CONNAUGHT LABS CONNAUGHT LABORATORIES 40040CA / 0 LL / IM
HIBV: HIBTITER HIB (HIBTITER) / LEDERLE(PRAXIS) LEDERLE PRAXSIS 530453A / 0 RL / IM
IPV: POLIOVAX POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD CONNAUGHT LTD. PO257 / 0 LL / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Respiratory arrest, APNEA

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-04-01
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
CDC 'Split Type':

Write-up: Pt was well and went to sleep at approximately 10:30 pm. Found at 6:00 am not breathing. Pt had been put to sleep on her side but was found on stomach.


Changed on 5/14/2017

VAERS ID: 150931 Before After
VAERS Form:
Age:0.2
Sex:Female
Location:Massachusetts
Vaccinated:2000-03-31
Onset:2000-04-01
Submitted:2000-04-04
Entered:2000-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 40040CA / 0 LL / IM
HIBV: HIB (HIBTITER) / LEDERLE PRAXSIS PFIZER/WYETH 530453A / 0 RL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. PO257 / 0 LL / IM

Administered by: Private      Purchased by: Private
Symptoms: Respiratory arrest

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-04-01
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
CDC 'Split Type':

Write-up: Pt was well and went to sleep at approximately 10:30 pm. Found at 6:00 am not breathing. Pt had been put to sleep on her side but was found on stomach.


Changed on 9/14/2017

VAERS ID: 150931 Before After
VAERS Form:(blank) 1
Age:0.2
Sex:Female
Location:Massachusetts
Vaccinated:2000-03-31
Onset:2000-04-01
Submitted:2000-04-04
Entered:2000-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 40040CA / 0 1 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH 530453A / 0 1 RL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. PO257 / 0 1 LL / IM

Administered by: Private      Purchased by: Private
Symptoms: Respiratory arrest

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-04-01
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
CDC 'Split Type':

Write-up: Pt was well and went to sleep at approximately 10:30 pm. Found at 6:00 am not breathing. Pt had been put to sleep on her side but was found on stomach.


Changed on 2/14/2018

VAERS ID: 150931 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:Massachusetts
Vaccinated:2000-03-31
Onset:2000-04-01
Submitted:2000-04-04
Entered:2000-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 40040CA / 1 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH 530453A / 1 RL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. PO257 / 1 LL / IM

Administered by: Private      Purchased by: Private
Symptoms: Respiratory arrest

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-04-01
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
CDC 'Split Type':

Write-up: Pt was well and went to sleep at approximately 10:30 pm. Found at 6:00 am not breathing. Pt had been put to sleep on her side but was found on stomach.


Changed on 6/14/2018

VAERS ID: 150931 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:Massachusetts
Vaccinated:2000-03-31
Onset:2000-04-01
Submitted:2000-04-04
Entered:2000-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 40040CA / 1 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH 530453A / 1 RL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. PO257 / 1 LL / IM

Administered by: Private      Purchased by: Private
Symptoms: Respiratory arrest

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-04-01
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
CDC 'Split Type':

Write-up: Pt was well and went to sleep at approximately 10:30 pm. Found at 6:00 am not breathing. Pt had been put to sleep on her side but was found on stomach.


Changed on 8/14/2018

VAERS ID: 150931 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:Massachusetts
Vaccinated:2000-03-31
Onset:2000-04-01
Submitted:2000-04-04
Entered:2000-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 40040CA / 1 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH 530453A / 1 RL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. PO257 / 1 LL / IM

Administered by: Private      Purchased by: Private
Symptoms: Respiratory arrest

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-04-01
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
CDC 'Split Type':

Write-up: Pt was well and went to sleep at approximately 10:30 pm. Found at 6:00 am not breathing. Pt had been put to sleep on her side but was found on stomach.


Changed on 9/14/2018

VAERS ID: 150931 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:Massachusetts
Vaccinated:2000-03-31
Onset:2000-04-01
Submitted:2000-04-04
Entered:2000-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 40040CA / 1 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH 530453A / 1 RL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. PO257 / 1 LL / IM

Administered by: Private      Purchased by: Private
Symptoms: Respiratory arrest

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-04-01
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
CDC 'Split Type':

Write-up: Pt was well and went to sleep at approximately 10:30 pm. Found at 6:00 am not breathing. Pt had been put to sleep on her side but was found on stomach.


Changed on 10/14/2018

VAERS ID: 150931 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:Massachusetts
Vaccinated:2000-03-31
Onset:2000-04-01
Submitted:2000-04-04
Entered:2000-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 40040CA / 1 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH 530453A / 1 RL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. PO257 / 1 LL / IM

Administered by: Private      Purchased by: Private
Symptoms: Respiratory arrest

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-04-01
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
CDC 'Split Type':

Write-up: Pt was well and went to sleep at approximately 10:30 pm. Found at 6:00 am not breathing. Pt had been put to sleep on her side but was found on stomach.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=150931&WAYBACKHISTORY=ON


Copyright © 2020 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166