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This is VAERS ID 162990

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 162990
VAERS Form:
Age:0.1
Sex:Female
Location:North Carolina
Vaccinated:2000-09-29
Onset:2000-10-01
Submitted:0000-00-00
Entered:2000-12-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: ENGERIX-B / SMITHKLINE ENG5151A2 / 1 LL / IM

Administered by: Private      Purchased by: Unknown
Symptoms: SIDS, REACT UNEVAL, APNEA, PHARYNGITIS

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-10-01
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: NONE
CDC 'Split Type':

Write-up: NONE Autopsy shows infant had upper respiratory infection week before death, found not breathing. Cause of death given as sudden infant death syndrome.


Changed on 12/8/2009

VAERS ID: 162990 Before After
VAERS Form:
Age:0.1
Sex:Female
Location:North Carolina
Vaccinated:2000-09-29
Onset:2000-10-01
Submitted:0000-00-00
Entered:2000-12-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: ENGERIX-B HEP B (ENGERIX-B) / SMITHKLINE SMITHKLINE BEECHAM ENG5151A2 5151A2 / 1 LL / IM

Administered by: Private      Purchased by: Unknown Public
Symptoms: Apnoea, SIDS, Sudden infant death syndrome, Upper respiratory tract infection, Unevaluable event, REACT UNEVAL, APNEA, PHARYNGITIS

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-10-01
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: NONE
CDC 'Split Type': (blank) NC00092

Write-up: NONE Autopsy shows infant had upper respiratory infection week before death, found not breathing. Cause of death given as sudden infant death syndrome.


Changed on 2/14/2017

VAERS ID: 162990 Before After
VAERS Form:
Age:0.1 0.08
Sex:Female
Location:North Carolina
Vaccinated:2000-09-29
Onset:2000-10-01
Submitted:0000-00-00
Entered:2000-12-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 5151A2 / 1 LL / IM

Administered by: Private      Purchased by: Public
Symptoms: Apnoea, Sudden infant death syndrome, Upper respiratory tract infection, Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-10-01
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: NONE
CDC 'Split Type': NC00092

Write-up: NONE Autopsy shows infant had upper respiratory infection week before death, found not breathing. Cause of death given as sudden infant death syndrome.


Changed on 9/14/2017

VAERS ID: 162990 Before After
VAERS Form:(blank) 1
Age:0.08
Sex:Female
Location:North Carolina
Vaccinated:2000-09-29
Onset:2000-10-01
Submitted:0000-00-00
Entered:2000-12-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 5151A2 / 1 2 LL / IM

Administered by: Private      Purchased by: Public
Symptoms: Apnoea, Sudden infant death syndrome, Upper respiratory tract infection, Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-10-01
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: NONE
CDC 'Split Type': NC00092

Write-up: NONE Autopsy shows infant had upper respiratory infection week before death, found not breathing. Cause of death given as sudden infant death syndrome.


Changed on 2/14/2018

VAERS ID: 162990 Before After
VAERS Form:1
Age:0.08
Sex:Female
Location:North Carolina
Vaccinated:2000-09-29
Onset:2000-10-01
Submitted:0000-00-00
Entered:2000-12-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 5151A2 / 2 LL / IM

Administered by: Private      Purchased by: Public
Symptoms: Apnoea, Sudden infant death syndrome, Upper respiratory tract infection, Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-10-01
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: NONE
CDC 'Split Type': NC00092

Write-up: NONE Autopsy shows infant had upper respiratory infection week before death, found not breathing. Cause of death given as sudden infant death syndrome.


Changed on 6/14/2018

VAERS ID: 162990 Before After
VAERS Form:1
Age:0.08
Sex:Female
Location:North Carolina
Vaccinated:2000-09-29
Onset:2000-10-01
Submitted:0000-00-00
Entered:2000-12-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 5151A2 / 2 LL / IM

Administered by: Private      Purchased by: Public
Symptoms: Apnoea, Sudden infant death syndrome, Upper respiratory tract infection, Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-10-01
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: NONE
CDC 'Split Type': NC00092

Write-up: NONE Autopsy shows infant had upper respiratory infection week before death, found not breathing. Cause of death given as sudden infant death syndrome.


Changed on 8/14/2018

VAERS ID: 162990 Before After
VAERS Form:1
Age:0.08
Sex:Female
Location:North Carolina
Vaccinated:2000-09-29
Onset:2000-10-01
Submitted:0000-00-00
Entered:2000-12-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 5151A2 / 2 LL / IM

Administered by: Private      Purchased by: Public
Symptoms: Apnoea, Sudden infant death syndrome, Upper respiratory tract infection, Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-10-01
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: NONE
CDC 'Split Type': NC00092

Write-up: NONE Autopsy shows infant had upper respiratory infection week before death, found not breathing. Cause of death given as sudden infant death syndrome.


Changed on 9/14/2018

VAERS ID: 162990 Before After
VAERS Form:1
Age:0.08
Sex:Female
Location:North Carolina
Vaccinated:2000-09-29
Onset:2000-10-01
Submitted:0000-00-00
Entered:2000-12-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 5151A2 / 2 LL / IM

Administered by: Private      Purchased by: Public
Symptoms: Apnoea, Sudden infant death syndrome, Upper respiratory tract infection, Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-10-01
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: NONE
CDC 'Split Type': NC00092

Write-up: NONE Autopsy shows infant had upper respiratory infection week before death, found not breathing. Cause of death given as sudden infant death syndrome.


Changed on 10/14/2018

VAERS ID: 162990 Before After
VAERS Form:1
Age:0.08
Sex:Female
Location:North Carolina
Vaccinated:2000-09-29
Onset:2000-10-01
Submitted:0000-00-00
Entered:2000-12-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 5151A2 / 2 LL / IM

Administered by: Private      Purchased by: Public
Symptoms: Apnoea, Sudden infant death syndrome, Upper respiratory tract infection, Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-10-01
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: NONE
CDC 'Split Type': NC00092

Write-up: NONE Autopsy shows infant had upper respiratory infection week before death, found not breathing. Cause of death given as sudden infant death syndrome.

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