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This is VAERS ID 161757

Case Details

VAERS ID: 161757 (history)  
Form: Version 1.0  
Age: 4.0  
Sex: Female  
Location: Nevada  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2000-11-07
Entered: 2000-11-10
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / 2 - / IM

Administered by: Other       Purchased by: Other
Symptoms: Cardiac disorder
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: The pt had a sibling that died from crib death "years ago"
Allergies:
Diagnostic Lab Data:
CDC Split Type: 20000321491

Write-up: Two weeks following dose 2 of Engerix-B, the vaccinee died. The autopsy showed that the vaccinee had a hole in her heart.


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