National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 459685

Case Details

VAERS ID: 459685 (history)  
Form: Version 1.0  
Age: 0.17  
Sex: Female  
Location: Arkansas  
Vaccinated:2012-06-29
Onset:2012-06-30
   Days after vaccination:1
Submitted: 2012-07-19
   Days after onset:19
Entered: 2012-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C4195AA / 1 LL / IM
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVC044AA / 2 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F56178 / 1 RL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41CBZ68A / 1 MO / PO

Administered by: Public       Purchased by: Public
Symptoms: Death, Endotracheal intubation, Resuscitation, Unresponsive to stimuli
SMQs:, Angioedema (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Respiratory failure (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2012-06-30
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: born 5 weeks premature
Allergies:
Diagnostic Lab Data: Autopsy to be performed. Hospital records will be sent to VAERS via regular mail.
CDC Split Type: AR1216

Write-up: Found unresponsive by parents just after midnight 6/30/12, transported to local hospital with external CPR by EMS. ER able to intubate and establish HR, then transferred to another hospital. Died at 2148 on 6/30/12.


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=459685


Copyright © 2020 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166