National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts.org
Search Results

From the 1/14/2022 release of VAERS data:

This is VAERS ID 455358

Government Disclaimer on use of this data



Case Details

VAERS ID: 455358 (history)  
Form: Version 1.0  
Age: 1.03  
Sex: Male  
Location: Florida  
Vaccinated:2012-03-01
Onset:2012-03-05
   Days after vaccination:4
Submitted: 2012-03-26
   Days after onset:20
Entered: 2012-05-11
   Days after submission:46
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 1531AA / 3 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0872AA / 1 LA / SC
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH F18963 / 4 RL / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0976AA / 1 RA / SC

Administered by: Public       Purchased by: Public
Symptoms: Autopsy, Death, Toxicologic test
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2012-03-05
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: LOTRIMIN cream BID - Rx written on 3/1/12
Current Illness: None
Preexisting Conditions: Eczema 3/1/12; Tinea corporis 3/1/12
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Pt. died of unknown causes. Autopsy. Toxicology testing in process.


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=455358


Copyright © 2022 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166