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This is VAERS ID 161811

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 161811
VAERS Form:
Age:0.2
Sex:Female
Location:Louisiana
Vaccinated:2000-09-08
Onset:2000-09-16
Submitted:2000-11-06
Entered:2000-11-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: ACEL-IMUNE / LEDERLE 467008 / 0 - / IM
HBHEPB: COMVAX / MSD 0289K / 0 - / IM
PNC: PREVNAR / LEDERLE 469692 / 0 - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: SIDS, RHINITIS, EDEMA LUNG, PHARYNGITIS, CARDIOVASC DIS

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-09-16
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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy; blood cultures-all results neg-SIDS
CDC 'Split Type':

Write-up: Post vax, the pt developed URI symptoms. Was seen in office on 9/14/00 with nasal congestion. She had a cardiac event on 9/16/00 and died. Autopsy revealed SIDS. Autopsy shows pulmonary edema.


Changed on 12/8/2009

VAERS ID: 161811 Before After
VAERS Form:
Age:0.2
Sex:Female
Location:Louisiana
Vaccinated:2000-09-08
Onset:2000-09-16
Submitted:2000-11-06
Entered:2000-11-15 2000-11-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: ACEL-IMUNE DTAP (ACEL-IMUNE) / LEDERLE LEDERLE LABORATORIES 467008 / 0 - / IM
HBHEPB: COMVAX HIB + HEP B (COMVAX) / MSD MERCK & CO. INC. 0289K / 0 - / IM
PNC: PREVNAR PNEUMO (PREVNAR) / LEDERLE LEDERLE LABORATORIES 469692 / 0 - / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Nasal congestion, Pulmonary oedema, SIDS, Sudden infant death syndrome, Upper respiratory tract infection, Cardiac disorder, RHINITIS, EDEMA LUNG, PHARYNGITIS, CARDIOVASC DIS

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-09-16
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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy; blood cultures-all results neg-SIDS
CDC 'Split Type':

Write-up: Post vax, the pt developed URI symptoms. Was seen in office on 9/14/00 with nasal congestion. She had a cardiac event on 9/16/00 and died. Autopsy revealed SIDS. Autopsy shows pulmonary edema. .


Changed on 3/2/2010

VAERS ID: 161811 Before After
VAERS Form:
Age:0.2
Sex:Female
Location:Louisiana
Vaccinated:2000-09-08
Onset:2000-09-16
Submitted:2000-11-06
Entered:2000-11-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (ACEL-IMUNE) / LEDERLE LABORATORIES 467008 / 0 - / IM
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 0289K / 0 - / IM
PNC: PNEUMO (PREVNAR) PNEUMO (PREVNAR7) / LEDERLE LABORATORIES 469692 / 0 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Nasal congestion, Pulmonary oedema, Sudden infant death syndrome, Upper respiratory tract infection, Cardiac disorder

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-09-16
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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy; blood cultures-all results neg-SIDS
CDC 'Split Type':

Write-up: Post vax, the pt developed URI symptoms. Was seen in office on 9/14/00 with nasal congestion. She had a cardiac event on 9/16/00 and died. Autopsy revealed SIDS. Autopsy shows pulmonary edema. .


Changed on 4/7/2010

VAERS ID: 161811 Before After
VAERS Form:
Age:0.2
Sex:Female
Location:Louisiana
Vaccinated:2000-09-08
Onset:2000-09-16
Submitted:2000-11-06
Entered:2000-11-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (ACEL-IMUNE) / LEDERLE LABORATORIES 467008 / 0 - / IM
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 0289K / 0 - / IM
PNC: PNEUMO (PREVNAR7) PNEUMO (PREVNAR) / LEDERLE LABORATORIES 469692 / 0 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Nasal congestion, Pulmonary oedema, Sudden infant death syndrome, Upper respiratory tract infection, Cardiac disorder

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-09-16
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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy; blood cultures-all results neg-SIDS
CDC 'Split Type':

Write-up: Post vax, the pt developed URI symptoms. Was seen in office on 9/14/00 with nasal congestion. She had a cardiac event on 9/16/00 and died. Autopsy revealed SIDS. Autopsy shows pulmonary edema. .


Changed on 2/14/2017

VAERS ID: 161811 Before After
VAERS Form:
Age:0.2
Sex:Female
Location:Louisiana
Vaccinated:2000-09-08
Onset:2000-09-16
Submitted:2000-11-06
Entered:2000-11-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (ACEL-IMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 467008 / 0 - / IM
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 0289K / 0 - / IM
PNC: PNEUMO (PREVNAR) / LEDERLE LABORATORIES PFIZER/WYETH 469692 / 0 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Nasal congestion, Pulmonary oedema, Sudden infant death syndrome, Upper respiratory tract infection, Cardiac disorder

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-09-16
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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy; blood cultures-all results neg-SIDS
CDC 'Split Type':

Write-up: Post vax, the pt developed URI symptoms. Was seen in office on 9/14/00 with nasal congestion. She had a cardiac event on 9/16/00 and died. Autopsy revealed SIDS. Autopsy shows pulmonary edema. .


Changed on 9/14/2017

VAERS ID: 161811 Before After
VAERS Form:(blank) 1
Age:0.2
Sex:Female
Location:Louisiana
Vaccinated:2000-09-08
Onset:2000-09-16
Submitted:2000-11-06
Entered:2000-11-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (ACEL-IMUNE) / PFIZER/WYETH 467008 / 0 1 - / IM
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 0289K / 0 1 - / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH 469692 / 0 1 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Nasal congestion, Pulmonary oedema, Sudden infant death syndrome, Upper respiratory tract infection, Cardiac disorder

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-09-16
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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy; blood cultures-all results neg-SIDS
CDC 'Split Type':

Write-up: Post vax, the pt developed URI symptoms. Was seen in office on 9/14/00 with nasal congestion. She had a cardiac event on 9/16/00 and died. Autopsy revealed SIDS. Autopsy shows pulmonary edema.


Changed on 2/14/2018

VAERS ID: 161811 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:Louisiana
Vaccinated:2000-09-08
Onset:2000-09-16
Submitted:2000-11-06
Entered:2000-11-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (ACEL-IMUNE) / PFIZER/WYETH 467008 / 1 - / IM
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 0289K / 1 - / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH 469692 / 1 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Nasal congestion, Pulmonary oedema, Sudden infant death syndrome, Upper respiratory tract infection, Cardiac disorder

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-09-16
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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy; blood cultures-all results neg-SIDS
CDC 'Split Type':

Write-up: Post vax, the pt developed URI symptoms. Was seen in office on 9/14/00 with nasal congestion. She had a cardiac event on 9/16/00 and died. Autopsy revealed SIDS. Autopsy shows pulmonary edema.


Changed on 6/14/2018

VAERS ID: 161811 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:Louisiana
Vaccinated:2000-09-08
Onset:2000-09-16
Submitted:2000-11-06
Entered:2000-11-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (ACEL-IMUNE) / PFIZER/WYETH 467008 / 1 - / IM
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 0289K / 1 - / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH 469692 / 1 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Nasal congestion, Pulmonary oedema, Sudden infant death syndrome, Upper respiratory tract infection, Cardiac disorder

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-09-16
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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy; blood cultures-all results neg-SIDS
CDC 'Split Type':

Write-up: Post vax, the pt developed URI symptoms. Was seen in office on 9/14/00 with nasal congestion. She had a cardiac event on 9/16/00 and died. Autopsy revealed SIDS. Autopsy shows pulmonary edema.


Changed on 8/14/2018

VAERS ID: 161811 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:Louisiana
Vaccinated:2000-09-08
Onset:2000-09-16
Submitted:2000-11-06
Entered:2000-11-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (ACEL-IMUNE) / PFIZER/WYETH 467008 / 1 - / IM
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 0289K / 1 - / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH 469692 / 1 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Nasal congestion, Pulmonary oedema, Sudden infant death syndrome, Upper respiratory tract infection, Cardiac disorder

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-09-16
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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy; blood cultures-all results neg-SIDS
CDC 'Split Type':

Write-up: Post vax, the pt developed URI symptoms. Was seen in office on 9/14/00 with nasal congestion. She had a cardiac event on 9/16/00 and died. Autopsy revealed SIDS. Autopsy shows pulmonary edema.


Changed on 9/14/2018

VAERS ID: 161811 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:Louisiana
Vaccinated:2000-09-08
Onset:2000-09-16
Submitted:2000-11-06
Entered:2000-11-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (ACEL-IMUNE) / PFIZER/WYETH 467008 / 1 - / IM
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 0289K / 1 - / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH 469692 / 1 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Nasal congestion, Pulmonary oedema, Sudden infant death syndrome, Upper respiratory tract infection, Cardiac disorder

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-09-16
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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy; blood cultures-all results neg-SIDS
CDC 'Split Type':

Write-up: Post vax, the pt developed URI symptoms. Was seen in office on 9/14/00 with nasal congestion. She had a cardiac event on 9/16/00 and died. Autopsy revealed SIDS. Autopsy shows pulmonary edema.


Changed on 10/14/2018

VAERS ID: 161811 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:Louisiana
Vaccinated:2000-09-08
Onset:2000-09-16
Submitted:2000-11-06
Entered:2000-11-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (ACEL-IMUNE) / PFIZER/WYETH 467008 / 1 - / IM
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 0289K / 1 - / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH 469692 / 1 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Nasal congestion, Pulmonary oedema, Sudden infant death syndrome, Upper respiratory tract infection, Cardiac disorder

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-09-16
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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy; blood cultures-all results neg-SIDS
CDC 'Split Type':

Write-up: Post vax, the pt developed URI symptoms. Was seen in office on 9/14/00 with nasal congestion. She had a cardiac event on 9/16/00 and died. Autopsy revealed SIDS. Autopsy shows pulmonary edema.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=161811&WAYBACKHISTORY=ON


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