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This is VAERS ID 158477

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 158477
VAERS Form:
Age:0.2
Sex:Female
Location:New Mexico
Vaccinated:2000-07-31
Onset:2000-08-01
Submitted:2000-08-04
Entered:2000-08-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: TRIPEDIA / CONNAUGHT LABS U0137BA / 0 RL / IM
HBHEPB: COMVAX / MSD 0290K / 0 LL / IM
IPV: POLIOVAX / CONNAUGHT LTD R0668 / 0 RL / -

Administered by: Private      Purchased by: Unknown
Symptoms: SIDS, RHINITIS, LUNG DIS, CONJUNCTIVITIS, SEBORRHEA

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-08-01
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:
CDC 'Split Type':

Write-up: Death from SIDS. Autopsy shows congestion of thymus, lungs, adrenals and spleen. Also shows seborrhic dermatitis, conjunctivitis, unresponsive.


Changed on 12/8/2009

VAERS ID: 158477 Before After
VAERS Form:
Age:0.2
Sex:Female
Location:New Mexico
Vaccinated:2000-07-31
Onset:2000-08-01
Submitted:2000-08-04
Entered:2000-08-08 2000-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: TRIPEDIA DTAP (TRIPEDIA) / CONNAUGHT LABS CONNAUGHT LABORATORIES U0137BA / 0 RL / IM
HBHEPB: COMVAX HIB + HEP B (COMVAX) / MSD MERCK & CO. INC. 0290K / 0 LL / IM
IPV: POLIOVAX POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD CONNAUGHT LTD. R0668 / 0 RL / -

Administered by: Private      Purchased by: Unknown Public
Symptoms: Coma, Conjunctivitis, Nasal congestion, Pulmonary congestion, Seborrhoeic dermatitis, SIDS, Sudden infant death syndrome, RHINITIS, LUNG DIS, CONJUNCTIVITIS, SEBORRHEA

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-08-01
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:
CDC 'Split Type':

Write-up: Death from SIDS. Autopsy shows congestion of thymus, lungs, adrenals and spleen. Also shows seborrhic dermatitis, conjunctivitis, unresponsive. .


Changed on 5/14/2017

VAERS ID: 158477 Before After
VAERS Form:
Age:0.2
Sex:Female
Location:New Mexico
Vaccinated:2000-07-31
Onset:2000-08-01
Submitted:2000-08-04
Entered:2000-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES U0137BA / 0 RL / IM
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 0290K / 0 LL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. R0668 / 0 RL / -

Administered by: Private      Purchased by: Public
Symptoms: Coma, Conjunctivitis, Nasal congestion, Pulmonary congestion, Seborrhoeic dermatitis, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-08-01
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:
CDC 'Split Type':

Write-up: Death from SIDS. Autopsy shows congestion of thymus, lungs, adrenals and spleen. Also shows seborrhic dermatitis, conjunctivitis, unresponsive. .


Changed on 9/14/2017

VAERS ID: 158477 Before After
VAERS Form:(blank) 1
Age:0.2
Sex:Female
Location:New Mexico
Vaccinated:2000-07-31
Onset:2000-08-01
Submitted:2000-08-04
Entered:2000-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES U0137BA / 0 1 RL / IM
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 0290K / 0 1 LL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. R0668 / 0 1 RL / -

Administered by: Private      Purchased by: Public
Symptoms: Coma, Conjunctivitis, Nasal congestion, Pulmonary congestion, Seborrhoeic dermatitis, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-08-01
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:
CDC 'Split Type':

Write-up: Death from SIDS. Autopsy shows congestion of thymus, lungs, adrenals and spleen. Also shows seborrhic dermatitis, conjunctivitis, unresponsive.


Changed on 2/14/2018

VAERS ID: 158477 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:New Mexico
Vaccinated:2000-07-31
Onset:2000-08-01
Submitted:2000-08-04
Entered:2000-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES U0137BA / 1 RL / IM
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 0290K / 1 LL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. R0668 / 1 RL / -

Administered by: Private      Purchased by: Public
Symptoms: Coma, Conjunctivitis, Nasal congestion, Pulmonary congestion, Seborrhoeic dermatitis, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-08-01
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:
CDC 'Split Type':

Write-up: Death from SIDS. Autopsy shows congestion of thymus, lungs, adrenals and spleen. Also shows seborrhic dermatitis, conjunctivitis, unresponsive.


Changed on 6/14/2018

VAERS ID: 158477 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:New Mexico
Vaccinated:2000-07-31
Onset:2000-08-01
Submitted:2000-08-04
Entered:2000-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES U0137BA / 1 RL / IM
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 0290K / 1 LL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. R0668 / 1 RL / -

Administered by: Private      Purchased by: Public
Symptoms: Coma, Conjunctivitis, Nasal congestion, Pulmonary congestion, Seborrhoeic dermatitis, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-08-01
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:
CDC 'Split Type':

Write-up: Death from SIDS. Autopsy shows congestion of thymus, lungs, adrenals and spleen. Also shows seborrhic dermatitis, conjunctivitis, unresponsive.


Changed on 8/14/2018

VAERS ID: 158477 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:New Mexico
Vaccinated:2000-07-31
Onset:2000-08-01
Submitted:2000-08-04
Entered:2000-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES U0137BA / 1 RL / IM
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 0290K / 1 LL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. R0668 / 1 RL / -

Administered by: Private      Purchased by: Public
Symptoms: Coma, Conjunctivitis, Nasal congestion, Pulmonary congestion, Seborrhoeic dermatitis, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-08-01
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:
CDC 'Split Type':

Write-up: Death from SIDS. Autopsy shows congestion of thymus, lungs, adrenals and spleen. Also shows seborrhic dermatitis, conjunctivitis, unresponsive.


Changed on 9/14/2018

VAERS ID: 158477 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:New Mexico
Vaccinated:2000-07-31
Onset:2000-08-01
Submitted:2000-08-04
Entered:2000-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES U0137BA / 1 RL / IM
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 0290K / 1 LL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. R0668 / 1 RL / -

Administered by: Private      Purchased by: Public
Symptoms: Coma, Conjunctivitis, Nasal congestion, Pulmonary congestion, Seborrhoeic dermatitis, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-08-01
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:
CDC 'Split Type':

Write-up: Death from SIDS. Autopsy shows congestion of thymus, lungs, adrenals and spleen. Also shows seborrhic dermatitis, conjunctivitis, unresponsive.


Changed on 10/14/2018

VAERS ID: 158477 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:New Mexico
Vaccinated:2000-07-31
Onset:2000-08-01
Submitted:2000-08-04
Entered:2000-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES U0137BA / 1 RL / IM
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 0290K / 1 LL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. R0668 / 1 RL / -

Administered by: Private      Purchased by: Public
Symptoms: Coma, Conjunctivitis, Nasal congestion, Pulmonary congestion, Seborrhoeic dermatitis, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-08-01
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:
CDC 'Split Type':

Write-up: Death from SIDS. Autopsy shows congestion of thymus, lungs, adrenals and spleen. Also shows seborrhic dermatitis, conjunctivitis, unresponsive.

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