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This is VAERS ID 158749

Case Details

VAERS ID: 158749 (history)  
Form: Version 1.0  
Age:   
Sex: Unknown  
Location: Missouri  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2000-08-07
Entered: 2000-08-14
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. - / UNK - / IM

Administered by: Other       Purchased by: Other
Symptoms: Infection
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data:
CDC Split Type: WAES00072609

Write-up: Subsequently post vax, the pt developed hib disease, sought unspecified medical attention and died. This was due to haemophilus b recombinant vax causing decreased antibody levels than haemophilus b conjugate vax. A follow up report received 9/25/2000 adds: On 8/15/2000 called reporter - she has no further info except that vaccine was Hib titer, not Comvax, and that pt was in Tx. She will try to contact drug rep who passed info to her to get more info. Letter has been sent to MD concerning this report - As soon as she gets any feedback, she will pass it on to us. 9/25/2000: Pt did not die! Change to serious status.


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