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This is VAERS ID 159963

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 159963
VAERS Form:
Age:0.8
Sex:Female
Location:Massachusetts
Vaccinated:2000-09-13
Onset:2000-09-20
Submitted:2000-09-20
Entered:2000-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: RECOMBIVAX HB / MSD 0429K / 2 LL / IM
PNC: PREVNAR / LEDERLE 473334 / 0 RL / IM

Administered by: Private      Purchased by: Unknown
Symptoms: APNEA, HEART ARREST

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-09-20
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: Tylenol
Current Illness:
Preexisting Conditions: Initial low blood sugar
Allergies:
Diagnostic Lab Data: Autopsy pending; blood cultures-neg
CDC 'Split Type':

Write-up: The pt was found pulseless and apneic in crib at 08:00 on 9/20/00.


Changed on 12/8/2009

VAERS ID: 159963 Before After
VAERS Form:
Age:0.8
Sex:Female
Location:Massachusetts
Vaccinated:2000-09-13
Onset:2000-09-20
Submitted:2000-09-20
Entered:2000-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: RECOMBIVAX HB HEP B (RECOMBIVAX HB) / MSD MERCK & CO. INC. 0429K / 2 LL / IM
PNC: PREVNAR PNEUMO (PREVNAR) / LEDERLE LEDERLE LABORATORIES 473334 / 0 RL / IM

Administered by: Private      Purchased by: Unknown Public
Symptoms: Apnoea, Cardiac arrest, APNEA, HEART ARREST

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-09-20
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: Tylenol
Current Illness:
Preexisting Conditions: Initial low blood sugar
Allergies:
Diagnostic Lab Data: Autopsy pending; blood cultures-neg
CDC 'Split Type':

Write-up: The pt was found pulseless and apneic in crib at 08:00 on 9/20/00. 1


Changed on 3/2/2010

VAERS ID: 159963 Before After
VAERS Form:
Age:0.8
Sex:Female
Location:Massachusetts
Vaccinated:2000-09-13
Onset:2000-09-20
Submitted:2000-09-20
Entered:2000-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0429K / 2 LL / IM
PNC: PNEUMO (PREVNAR) PNEUMO (PREVNAR7) / LEDERLE LABORATORIES 473334 / 0 RL / IM

Administered by: Private      Purchased by: Public
Symptoms: Apnoea, Cardiac arrest

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-09-20
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: Tylenol
Current Illness:
Preexisting Conditions: Initial low blood sugar
Allergies:
Diagnostic Lab Data: Autopsy pending; blood cultures-neg
CDC 'Split Type':

Write-up: The pt was found pulseless and apneic in crib at 08:00 on 9/20/00. 1


Changed on 4/7/2010

VAERS ID: 159963 Before After
VAERS Form:
Age:0.8
Sex:Female
Location:Massachusetts
Vaccinated:2000-09-13
Onset:2000-09-20
Submitted:2000-09-20
Entered:2000-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0429K / 2 LL / IM
PNC: PNEUMO (PREVNAR7) PNEUMO (PREVNAR) / LEDERLE LABORATORIES 473334 / 0 RL / IM

Administered by: Private      Purchased by: Public
Symptoms: Apnoea, Cardiac arrest

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-09-20
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: Tylenol
Current Illness:
Preexisting Conditions: Initial low blood sugar
Allergies:
Diagnostic Lab Data: Autopsy pending; blood cultures-neg
CDC 'Split Type':

Write-up: The pt was found pulseless and apneic in crib at 08:00 on 9/20/00. 1


Changed on 5/14/2017

VAERS ID: 159963 Before After
VAERS Form:
Age:0.8
Sex:Female
Location:Massachusetts
Vaccinated:2000-09-13
Onset:2000-09-20
Submitted:2000-09-20
Entered:2000-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0429K / 2 LL / IM
PNC: PNEUMO (PREVNAR) / LEDERLE LABORATORIES PFIZER/WYETH 473334 / 0 RL / IM

Administered by: Private      Purchased by: Public
Symptoms: Apnoea, Cardiac arrest

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-09-20
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: Tylenol
Current Illness:
Preexisting Conditions: Initial low blood sugar
Allergies:
Diagnostic Lab Data: Autopsy pending; blood cultures-neg
CDC 'Split Type':

Write-up: The pt was found pulseless and apneic in crib at 08:00 on 9/20/00. 1


Changed on 9/14/2017

VAERS ID: 159963 Before After
VAERS Form:(blank) 1
Age:0.8
Sex:Female
Location:Massachusetts
Vaccinated:2000-09-13
Onset:2000-09-20
Submitted:2000-09-20
Entered:2000-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0429K / 2 3 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH 473334 / 0 1 RL / IM

Administered by: Private      Purchased by: Public
Symptoms: Apnoea, Cardiac arrest

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-09-20
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: Tylenol
Current Illness:
Preexisting Conditions: Initial low blood sugar
Allergies:
Diagnostic Lab Data: Autopsy pending; blood cultures-neg
CDC 'Split Type':

Write-up: The pt was found pulseless and apneic in crib at 08:00 on 9/20/00.


Changed on 2/14/2018

VAERS ID: 159963 Before After
VAERS Form:1
Age:0.8
Sex:Female
Location:Massachusetts
Vaccinated:2000-09-13
Onset:2000-09-20
Submitted:2000-09-20
Entered:2000-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0429K / 3 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH 473334 / 1 RL / IM

Administered by: Private      Purchased by: Public
Symptoms: Apnoea, Cardiac arrest

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-09-20
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: Tylenol
Current Illness:
Preexisting Conditions: Initial low blood sugar
Allergies:
Diagnostic Lab Data: Autopsy pending; blood cultures-neg
CDC 'Split Type':

Write-up: The pt was found pulseless and apneic in crib at 08:00 on 9/20/00.


Changed on 6/14/2018

VAERS ID: 159963 Before After
VAERS Form:1
Age:0.8
Sex:Female
Location:Massachusetts
Vaccinated:2000-09-13
Onset:2000-09-20
Submitted:2000-09-20
Entered:2000-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0429K / 3 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH 473334 / 1 RL / IM

Administered by: Private      Purchased by: Public
Symptoms: Apnoea, Cardiac arrest

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-09-20
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: Tylenol
Current Illness:
Preexisting Conditions: Initial low blood sugar
Allergies:
Diagnostic Lab Data: Autopsy pending; blood cultures-neg
CDC 'Split Type':

Write-up: The pt was found pulseless and apneic in crib at 08:00 on 9/20/00.


Changed on 8/14/2018

VAERS ID: 159963 Before After
VAERS Form:1
Age:0.8
Sex:Female
Location:Massachusetts
Vaccinated:2000-09-13
Onset:2000-09-20
Submitted:2000-09-20
Entered:2000-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0429K / 3 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH 473334 / 1 RL / IM

Administered by: Private      Purchased by: Public
Symptoms: Apnoea, Cardiac arrest

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-09-20
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: Tylenol
Current Illness:
Preexisting Conditions: Initial low blood sugar
Allergies:
Diagnostic Lab Data: Autopsy pending; blood cultures-neg
CDC 'Split Type':

Write-up: The pt was found pulseless and apneic in crib at 08:00 on 9/20/00.


Changed on 9/14/2018

VAERS ID: 159963 Before After
VAERS Form:1
Age:0.8
Sex:Female
Location:Massachusetts
Vaccinated:2000-09-13
Onset:2000-09-20
Submitted:2000-09-20
Entered:2000-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0429K / 3 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH 473334 / 1 RL / IM

Administered by: Private      Purchased by: Public
Symptoms: Apnoea, Cardiac arrest

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-09-20
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: Tylenol
Current Illness:
Preexisting Conditions: Initial low blood sugar
Allergies:
Diagnostic Lab Data: Autopsy pending; blood cultures-neg
CDC 'Split Type':

Write-up: The pt was found pulseless and apneic in crib at 08:00 on 9/20/00.


Changed on 10/14/2018

VAERS ID: 159963 Before After
VAERS Form:1
Age:0.8
Sex:Female
Location:Massachusetts
Vaccinated:2000-09-13
Onset:2000-09-20
Submitted:2000-09-20
Entered:2000-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0429K / 3 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH 473334 / 1 RL / IM

Administered by: Private      Purchased by: Public
Symptoms: Apnoea, Cardiac arrest

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-09-20
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: Tylenol
Current Illness:
Preexisting Conditions: Initial low blood sugar
Allergies:
Diagnostic Lab Data: Autopsy pending; blood cultures-neg
CDC 'Split Type':

Write-up: The pt was found pulseless and apneic in crib at 08:00 on 9/20/00.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=159963&WAYBACKHISTORY=ON


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