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This is VAERS ID 151748

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 151748
VAERS Form:
Age:0.3
Sex:Male
Location:Pennsylvania
Vaccinated:2000-03-22
Onset:2000-04-17
Submitted:2000-04-20
Entered:2000-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: INFANRIX / SMITHKLINE 918A2 / 0 LL / IM
HBHEPB: COMVAX / MSD 14775 / 0 RL / IM
IPV: IPV / MERIEUX INST P09052 / 0 LA / SC

Administered by: Private      Purchased by: Unknown
Symptoms: SIDS

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-04-17
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: hydrocortisone for dermatitis 3/22/2000
Current Illness: NONE
Preexisting Conditions: Possible milk protein allergy, dermatitis.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: SIDS death within one months of IZ. Autopsy being performed.


Changed on 12/8/2009

VAERS ID: 151748 Before After
VAERS Form:
Age:0.3
Sex:Male
Location:Pennsylvania
Vaccinated:2000-03-22
Onset:2000-04-17
Submitted:2000-04-20
Entered:2000-05-10 2000-05-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: INFANRIX DTAP (INFANRIX) / SMITHKLINE SMITHKLINE BEECHAM 918A2 / 0 LL / IM
HBHEPB: COMVAX HIB + HEP B (COMVAX) / MSD MERCK & CO. INC. 14775 / 0 RL / IM
IPV: IPV POLIO VIRUS, INACT. (NO BRAND NAME) / MERIEUX INST PASTEUR MERIEUX INST. P09052 / 0 LA / SC

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-04-17
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: hydrocortisone for dermatitis 3/22/2000
Current Illness: NONE
Preexisting Conditions: Possible milk protein allergy, dermatitis.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: SIDS death within one months of IZ. Autopsy being performed.


Changed on 2/14/2017

VAERS ID: 151748 Before After
VAERS Form:
Age:0.3 0.25
Sex:Male
Location:Pennsylvania
Vaccinated:2000-03-22
Onset:2000-04-17
Submitted:2000-04-20
Entered:2000-05-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / SMITHKLINE BEECHAM 918A2 / 0 LL / IM
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 14775 / 0 RL / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / PASTEUR MERIEUX INST. P09052 / 0 LA / SC

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-04-17
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: hydrocortisone for dermatitis 3/22/2000
Current Illness: NONE
Preexisting Conditions: Possible milk protein allergy, dermatitis.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: SIDS death within one months of IZ. Autopsy being performed.


Changed on 9/14/2017

VAERS ID: 151748 Before After
VAERS Form:(blank) 1
Age:0.25
Sex:Male
Location:Pennsylvania
Vaccinated:2000-03-22
Onset:2000-04-17
Submitted:2000-04-20
Entered:2000-05-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / SMITHKLINE BEECHAM 918A2 / 0 1 LL / IM
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 14775 / 0 1 RL / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / PASTEUR MERIEUX INST. P09052 / 0 1 LA / SC

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-04-17
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: hydrocortisone for dermatitis 3/22/2000
Current Illness: NONE
Preexisting Conditions: Possible milk protein allergy, dermatitis.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: SIDS death within one months of IZ. Autopsy being performed.


Changed on 2/14/2018

VAERS ID: 151748 Before After
VAERS Form:1
Age:0.25
Sex:Male
Location:Pennsylvania
Vaccinated:2000-03-22
Onset:2000-04-17
Submitted:2000-04-20
Entered:2000-05-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / SMITHKLINE BEECHAM 918A2 / 1 LL / IM
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 14775 / 1 RL / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / PASTEUR MERIEUX INST. P09052 / 1 LA / SC

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-04-17
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: hydrocortisone for dermatitis 3/22/2000
Current Illness: NONE
Preexisting Conditions: Possible milk protein allergy, dermatitis.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: SIDS death within one months of IZ. Autopsy being performed.


Changed on 6/14/2018

VAERS ID: 151748 Before After
VAERS Form:1
Age:0.25
Sex:Male
Location:Pennsylvania
Vaccinated:2000-03-22
Onset:2000-04-17
Submitted:2000-04-20
Entered:2000-05-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / SMITHKLINE BEECHAM 918A2 / 1 LL / IM
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 14775 / 1 RL / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / PASTEUR MERIEUX INST. P09052 / 1 LA / SC

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-04-17
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: hydrocortisone for dermatitis 3/22/2000
Current Illness: NONE
Preexisting Conditions: Possible milk protein allergy, dermatitis.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: SIDS death within one months of IZ. Autopsy being performed.


Changed on 8/14/2018

VAERS ID: 151748 Before After
VAERS Form:1
Age:0.25
Sex:Male
Location:Pennsylvania
Vaccinated:2000-03-22
Onset:2000-04-17
Submitted:2000-04-20
Entered:2000-05-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / SMITHKLINE BEECHAM 918A2 / 1 LL / IM
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 14775 / 1 RL / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / PASTEUR MERIEUX INST. P09052 / 1 LA / SC

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-04-17
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: hydrocortisone for dermatitis 3/22/2000
Current Illness: NONE
Preexisting Conditions: Possible milk protein allergy, dermatitis.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: SIDS death within one months of IZ. Autopsy being performed.


Changed on 9/14/2018

VAERS ID: 151748 Before After
VAERS Form:1
Age:0.25
Sex:Male
Location:Pennsylvania
Vaccinated:2000-03-22
Onset:2000-04-17
Submitted:2000-04-20
Entered:2000-05-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / SMITHKLINE BEECHAM 918A2 / 1 LL / IM
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 14775 / 1 RL / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / PASTEUR MERIEUX INST. P09052 / 1 LA / SC

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-04-17
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: hydrocortisone for dermatitis 3/22/2000
Current Illness: NONE
Preexisting Conditions: Possible milk protein allergy, dermatitis.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: SIDS death within one months of IZ. Autopsy being performed.


Changed on 10/14/2018

VAERS ID: 151748 Before After
VAERS Form:1
Age:0.25
Sex:Male
Location:Pennsylvania
Vaccinated:2000-03-22
Onset:2000-04-17
Submitted:2000-04-20
Entered:2000-05-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / SMITHKLINE BEECHAM 918A2 / 1 LL / IM
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 14775 / 1 RL / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / PASTEUR MERIEUX INST. P09052 / 1 LA / SC

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-04-17
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: hydrocortisone for dermatitis 3/22/2000
Current Illness: NONE
Preexisting Conditions: Possible milk protein allergy, dermatitis.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: SIDS death within one months of IZ. Autopsy being performed.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=151748&WAYBACKHISTORY=ON


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