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This is VAERS ID 156329

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 156329
VAERS Form:
Age:0.2
Sex:Male
Location:Mississippi
Vaccinated:2000-05-31
Onset:2000-06-01
Submitted:2000-06-30
Entered:2000-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: TRIPEDIA / CONNAUGHT LABS U0056FA / 0 LL / IM
HBHEPB: COMVAX / MSD 0053K / 0 RL / IM
IPV: IPV / MERIEUX INST P0997 / 0 RL / IM

Administered by: Public      Purchased by: Unknown
Symptoms: RHINITIS, APNEA, EDEMA LUNG, LUNG DIS, SALIVA INC

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-06-01
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:
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: Autopsy-pending (SIDS)
CDC 'Split Type':

Write-up: Post vax, on 6/1/2000 AM, the mother stated that infant was fine when he was put in bed with her and then when she tried to awaken the child, he was lying on his stomach with mucus from mouth and not breathing. Autopsy shows cause of death as sudden infan"t death, pulmonary congestion and edema, splenic congestion, renal congestion, unresponsive.


Changed on 12/8/2009

VAERS ID: 156329 Before After
VAERS Form:
Age:0.2
Sex:Male
Location:Mississippi
Vaccinated:2000-05-31
Onset:2000-06-01
Submitted:2000-06-30
Entered:2000-07-12 2000-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: TRIPEDIA DTAP (TRIPEDIA) / CONNAUGHT LABS CONNAUGHT LABORATORIES U0056FA / 0 LL / IM
HBHEPB: COMVAX HIB + HEP B (COMVAX) / MSD MERCK & CO. INC. 0053K / 0 RL / IM
IPV: IPV POLIO VIRUS, INACT. (NO BRAND NAME) / MERIEUX INST PASTEUR MERIEUX INST. P0997 / 0 RL / IM

Administered by: Public      Purchased by: Unknown Other
Symptoms: Apnoea, Coma, Nasal congestion, Pulmonary congestion, Pulmonary oedema, Salivary hypersecretion, Sudden infant death syndrome, RHINITIS, APNEA, EDEMA LUNG, LUNG DIS, SALIVA INC

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-06-01
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:
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: Autopsy-pending (SIDS)
CDC 'Split Type': (blank) MS00026

Write-up: Post vax, on 6/1/2000 AM, the mother stated that infant was fine when he was put in bed with her and then when she tried to awaken the child, he was lying on his stomach with mucus from mouth and not breathing. Autopsy shows cause of death as sudden infan"t infant death, pulmonary congestion and edema, splenic congestion, renal congestion, unresponsive.


Changed on 9/14/2017

VAERS ID: 156329 Before After
VAERS Form:(blank) 1
Age:0.2
Sex:Male
Location:Mississippi
Vaccinated:2000-05-31
Onset:2000-06-01
Submitted:2000-06-30
Entered:2000-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES U0056FA / 0 1 LL / IM
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 0053K / 0 1 RL / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / PASTEUR MERIEUX INST. P0997 / 0 1 RL / IM

Administered by: Public      Purchased by: Other
Symptoms: Apnoea, Coma, Nasal congestion, Pulmonary congestion, Pulmonary oedema, Salivary hypersecretion, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-06-01
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:
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: Autopsy-pending (SIDS)
CDC 'Split Type': MS00026

Write-up: Post vax, on 6/1/2000 AM, the mother stated that infant was fine when he was put in bed with her and then when she tried to awaken the child, he was lying on his stomach with mucus from mouth and not breathing. Autopsy shows cause of death as sudden infant death, pulmonary congestion and edema, splenic congestion, renal congestion, unresponsive.


Changed on 2/14/2018

VAERS ID: 156329 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Mississippi
Vaccinated:2000-05-31
Onset:2000-06-01
Submitted:2000-06-30
Entered:2000-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES U0056FA / 1 LL / IM
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 0053K / 1 RL / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / PASTEUR MERIEUX INST. P0997 / 1 RL / IM

Administered by: Public      Purchased by: Other
Symptoms: Apnoea, Coma, Nasal congestion, Pulmonary congestion, Pulmonary oedema, Salivary hypersecretion, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-06-01
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:
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: Autopsy-pending (SIDS)
CDC 'Split Type': MS00026

Write-up: Post vax, on 6/1/2000 AM, the mother stated that infant was fine when he was put in bed with her and then when she tried to awaken the child, he was lying on his stomach with mucus from mouth and not breathing. Autopsy shows cause of death as sudden infant death, pulmonary congestion and edema, splenic congestion, renal congestion, unresponsive.


Changed on 6/14/2018

VAERS ID: 156329 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Mississippi
Vaccinated:2000-05-31
Onset:2000-06-01
Submitted:2000-06-30
Entered:2000-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES U0056FA / 1 LL / IM
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 0053K / 1 RL / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / PASTEUR MERIEUX INST. P0997 / 1 RL / IM

Administered by: Public      Purchased by: Other
Symptoms: Apnoea, Coma, Nasal congestion, Pulmonary congestion, Pulmonary oedema, Salivary hypersecretion, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-06-01
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:
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: Autopsy-pending (SIDS)
CDC 'Split Type': MS00026

Write-up: Post vax, on 6/1/2000 AM, the mother stated that infant was fine when he was put in bed with her and then when she tried to awaken the child, he was lying on his stomach with mucus from mouth and not breathing. Autopsy shows cause of death as sudden infant death, pulmonary congestion and edema, splenic congestion, renal congestion, unresponsive.


Changed on 8/14/2018

VAERS ID: 156329 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Mississippi
Vaccinated:2000-05-31
Onset:2000-06-01
Submitted:2000-06-30
Entered:2000-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES U0056FA / 1 LL / IM
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 0053K / 1 RL / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / PASTEUR MERIEUX INST. P0997 / 1 RL / IM

Administered by: Public      Purchased by: Other
Symptoms: Apnoea, Coma, Nasal congestion, Pulmonary congestion, Pulmonary oedema, Salivary hypersecretion, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-06-01
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:
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: Autopsy-pending (SIDS)
CDC 'Split Type': MS00026

Write-up: Post vax, on 6/1/2000 AM, the mother stated that infant was fine when he was put in bed with her and then when she tried to awaken the child, he was lying on his stomach with mucus from mouth and not breathing. Autopsy shows cause of death as sudden infant death, pulmonary congestion and edema, splenic congestion, renal congestion, unresponsive.


Changed on 9/14/2018

VAERS ID: 156329 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Mississippi
Vaccinated:2000-05-31
Onset:2000-06-01
Submitted:2000-06-30
Entered:2000-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES U0056FA / 1 LL / IM
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 0053K / 1 RL / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / PASTEUR MERIEUX INST. P0997 / 1 RL / IM

Administered by: Public      Purchased by: Other
Symptoms: Apnoea, Coma, Nasal congestion, Pulmonary congestion, Pulmonary oedema, Salivary hypersecretion, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-06-01
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:
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: Autopsy-pending (SIDS)
CDC 'Split Type': MS00026

Write-up: Post vax, on 6/1/2000 AM, the mother stated that infant was fine when he was put in bed with her and then when she tried to awaken the child, he was lying on his stomach with mucus from mouth and not breathing. Autopsy shows cause of death as sudden infant death, pulmonary congestion and edema, splenic congestion, renal congestion, unresponsive.


Changed on 10/14/2018

VAERS ID: 156329 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Mississippi
Vaccinated:2000-05-31
Onset:2000-06-01
Submitted:2000-06-30
Entered:2000-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES U0056FA / 1 LL / IM
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 0053K / 1 RL / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / PASTEUR MERIEUX INST. P0997 / 1 RL / IM

Administered by: Public      Purchased by: Other
Symptoms: Apnoea, Coma, Nasal congestion, Pulmonary congestion, Pulmonary oedema, Salivary hypersecretion, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-06-01
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:
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: Autopsy-pending (SIDS)
CDC 'Split Type': MS00026

Write-up: Post vax, on 6/1/2000 AM, the mother stated that infant was fine when he was put in bed with her and then when she tried to awaken the child, he was lying on his stomach with mucus from mouth and not breathing. Autopsy shows cause of death as sudden infant death, pulmonary congestion and edema, splenic congestion, renal congestion, unresponsive.

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