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This is VAERS ID 161098

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 161098
VAERS Form:
Age:0.2
Sex:Male
Location:Illinois
Vaccinated:2000-10-25
Onset:2000-10-26
Submitted:0000-00-00
Entered:2000-10-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: INFANRIX / SMITHKLINE 941A2 / 0 LL / IM
HBHEPB: COMVAX / MSD 1945J / 0 LL / IM
IPV: IPV / MERIEUX INST R1433 / 0 RL / IM

Administered by: Private      Purchased by: Unknown
Symptoms: APNEA, DYSPNEA, HEART ARREST, LUNG DIS, ASPHYXIA

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-10-26
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 for fever
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Chest X-ray in ER-no cardiopulmonary process
CDC 'Split Type':

Write-up: Pt received vaccines on 10/25/00 and on 10/26/00, infant asleep with 16 year old sibling. Mother found arm of sibling across baby''s face and baby was not breathing. CPR was administered and intubation to no avail. Autopsy shows found unresponsive, congest"ion of lungs, kidneys congested. Final cause of death stated as suffocation by mechanical asphyxia.


Changed on 12/30/2006

VAERS ID: 161098 Before After
VAERS Form:
Age:0.2
Sex:Male
Location:Illinois
Vaccinated:2000-10-25
Onset:2000-10-26
Submitted:0000-00-00
Entered:2000-10-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: INFANRIX / SMITHKLINE 941A2 / 0 LL / IM
HBHEPB: COMVAX / MSD 1945J / 0 LL / IM
IPV: IPV / MERIEUX INST R1433 / 0 RL / IM

Administered by: Private      Purchased by: Unknown
Symptoms: APNEA, DYSPNEA, HEART ARREST, LUNG DIS, ASPHYXIA

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-10-26
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 for fever
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Chest X-ray in ER-no cardiopulmonary process
CDC 'Split Type':

Write-up: Pt received vaccines on 10/25/00 and on 10/26/00, infant asleep with 16 year old sibling. Mother found arm of sibling across baby''s baby''''s face and baby was not breathing. CPR was administered and intubation to no avail. Autopsy shows found unresponsive, congest"ion conges"tion of lungs, kidneys congested. Final cause of death stated as suffocation by mechanical asphyxia.


Changed on 12/8/2009

VAERS ID: 161098 Before After
VAERS Form:
Age:0.2
Sex:Male
Location:Illinois
Vaccinated:2000-10-25
Onset:2000-10-26
Submitted:0000-00-00
Entered:2000-10-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: INFANRIX DTAP (INFANRIX) / SMITHKLINE SMITHKLINE BEECHAM 941A2 / 0 LL / IM
HBHEPB: COMVAX HIB + HEP B (COMVAX) / MSD MERCK & CO. INC. 1945J / 0 LL / IM
IPV: IPV POLIO VIRUS, INACT. (NO BRAND NAME) / MERIEUX INST PASTEUR MERIEUX INST. R1433 / 0 RL / IM

Administered by: Private      Purchased by: Unknown Public
Symptoms: Apnoea, Asphyxia, Cardiac arrest, Coma, Pulmonary congestion, Renal disorder, Suffocation feeling, APNEA, DYSPNEA, HEART ARREST, LUNG DIS, ASPHYXIA

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-10-26
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 for fever
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Chest X-ray in ER-no cardiopulmonary process
CDC 'Split Type':

Write-up: Pt received vaccines on 10/25/00 and on 10/26/00, infant asleep with 16 year old sibling. Mother found arm of sibling across baby''''s baby''s face and baby was not breathing. CPR was administered and intubation to no avail. Autopsy shows found unresponsive, conges"tion congestion of lungs, kidneys congested. Final cause of death stated as suffocation by mechanical asphyxia.


Changed on 9/14/2017

VAERS ID: 161098 Before After
VAERS Form:(blank) 1
Age:0.2
Sex:Male
Location:Illinois
Vaccinated:2000-10-25
Onset:2000-10-26
Submitted:0000-00-00
Entered:2000-10-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / SMITHKLINE BEECHAM 941A2 / 0 1 LL / IM
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 1945J / 0 1 LL / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / PASTEUR MERIEUX INST. R1433 / 0 1 RL / IM

Administered by: Private      Purchased by: Public
Symptoms: Apnoea, Asphyxia, Cardiac arrest, Coma, Pulmonary congestion, Renal disorder, Suffocation feeling

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-10-26
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 for fever
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Chest X-ray in ER-no cardiopulmonary process
CDC 'Split Type':

Write-up: Pt received vaccines on 10/25/00 and on 10/26/00, infant asleep with 16 year old sibling. Mother found arm of sibling across baby''s face and baby was not breathing. CPR was administered and intubation to no avail. Autopsy shows found unresponsive, congestion of lungs, kidneys congested. Final cause of death stated as suffocation by mechanical asphyxia.


Changed on 2/14/2018

VAERS ID: 161098 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Illinois
Vaccinated:2000-10-25
Onset:2000-10-26
Submitted:0000-00-00
Entered:2000-10-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / SMITHKLINE BEECHAM 941A2 / 1 LL / IM
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 1945J / 1 LL / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / PASTEUR MERIEUX INST. R1433 / 1 RL / IM

Administered by: Private      Purchased by: Public
Symptoms: Apnoea, Asphyxia, Cardiac arrest, Coma, Pulmonary congestion, Renal disorder, Suffocation feeling

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-10-26
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 for fever
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Chest X-ray in ER-no cardiopulmonary process
CDC 'Split Type':

Write-up: Pt received vaccines on 10/25/00 and on 10/26/00, infant asleep with 16 year old sibling. Mother found arm of sibling across baby''s face and baby was not breathing. CPR was administered and intubation to no avail. Autopsy shows found unresponsive, congestion of lungs, kidneys congested. Final cause of death stated as suffocation by mechanical asphyxia.


Changed on 6/14/2018

VAERS ID: 161098 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Illinois
Vaccinated:2000-10-25
Onset:2000-10-26
Submitted:0000-00-00
Entered:2000-10-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / SMITHKLINE BEECHAM 941A2 / 1 LL / IM
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 1945J / 1 LL / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / PASTEUR MERIEUX INST. R1433 / 1 RL / IM

Administered by: Private      Purchased by: Public
Symptoms: Apnoea, Asphyxia, Cardiac arrest, Coma, Pulmonary congestion, Renal disorder, Suffocation feeling

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-10-26
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 for fever
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Chest X-ray in ER-no cardiopulmonary process
CDC 'Split Type':

Write-up: Pt received vaccines on 10/25/00 and on 10/26/00, infant asleep with 16 year old sibling. Mother found arm of sibling across baby''s face and baby was not breathing. CPR was administered and intubation to no avail. Autopsy shows found unresponsive, congestion of lungs, kidneys congested. Final cause of death stated as suffocation by mechanical asphyxia.


Changed on 8/14/2018

VAERS ID: 161098 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Illinois
Vaccinated:2000-10-25
Onset:2000-10-26
Submitted:0000-00-00
Entered:2000-10-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / SMITHKLINE BEECHAM 941A2 / 1 LL / IM
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 1945J / 1 LL / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / PASTEUR MERIEUX INST. R1433 / 1 RL / IM

Administered by: Private      Purchased by: Public
Symptoms: Apnoea, Asphyxia, Cardiac arrest, Coma, Pulmonary congestion, Renal disorder, Suffocation feeling

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-10-26
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 for fever
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Chest X-ray in ER-no cardiopulmonary process
CDC 'Split Type':

Write-up: Pt received vaccines on 10/25/00 and on 10/26/00, infant asleep with 16 year old sibling. Mother found arm of sibling across baby''s face and baby was not breathing. CPR was administered and intubation to no avail. Autopsy shows found unresponsive, congestion of lungs, kidneys congested. Final cause of death stated as suffocation by mechanical asphyxia.


Changed on 9/14/2018

VAERS ID: 161098 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Illinois
Vaccinated:2000-10-25
Onset:2000-10-26
Submitted:0000-00-00
Entered:2000-10-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / SMITHKLINE BEECHAM 941A2 / 1 LL / IM
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 1945J / 1 LL / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / PASTEUR MERIEUX INST. R1433 / 1 RL / IM

Administered by: Private      Purchased by: Public
Symptoms: Apnoea, Asphyxia, Cardiac arrest, Coma, Pulmonary congestion, Renal disorder, Suffocation feeling

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-10-26
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 for fever
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Chest X-ray in ER-no cardiopulmonary process
CDC 'Split Type':

Write-up: Pt received vaccines on 10/25/00 and on 10/26/00, infant asleep with 16 year old sibling. Mother found arm of sibling across baby''s face and baby was not breathing. CPR was administered and intubation to no avail. Autopsy shows found unresponsive, congestion of lungs, kidneys congested. Final cause of death stated as suffocation by mechanical asphyxia.


Changed on 10/14/2018

VAERS ID: 161098 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Illinois
Vaccinated:2000-10-25
Onset:2000-10-26
Submitted:0000-00-00
Entered:2000-10-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / SMITHKLINE BEECHAM 941A2 / 1 LL / IM
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 1945J / 1 LL / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / PASTEUR MERIEUX INST. R1433 / 1 RL / IM

Administered by: Private      Purchased by: Public
Symptoms: Apnoea, Asphyxia, Cardiac arrest, Coma, Pulmonary congestion, Renal disorder, Suffocation feeling

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-10-26
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 for fever
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Chest X-ray in ER-no cardiopulmonary process
CDC 'Split Type':

Write-up: Pt received vaccines on 10/25/00 and on 10/26/00, infant asleep with 16 year old sibling. Mother found arm of sibling across baby''s face and baby was not breathing. CPR was administered and intubation to no avail. Autopsy shows found unresponsive, congestion of lungs, kidneys congested. Final cause of death stated as suffocation by mechanical asphyxia.

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