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This is VAERS ID 159131

Case Details

VAERS ID: 159131 (history)  
Form: Version 1.0  
Age: 0.8  
Sex: Female  
Location: Texas  
Vaccinated:2000-08-08
Onset:2000-08-10
   Days after vaccination:2
Submitted: 2000-09-24
   Days after onset:45
Entered: 2000-09-29
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0712K / 3 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH 471222 / 2 LL / IM

Administered by: Private       Purchased by: Private
Symptoms: Status epilepticus
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2000-09-24
   Days after onset: 45
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PPD/Connaught/C0046AA/LFA/0 previously
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: complete work up
CDC Split Type:

Write-up: Status epilepticus-simple partial (motor). Left body started about 48 hours after immunization.


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