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This is VAERS ID 483055

Case Details

VAERS ID: 483055 (history)  
Form: Version 1.0  
Age:   
Sex: Female  
Location: New Hampshire  
Vaccinated:2012-10-05
Onset:2012-11-05
   Days after vaccination:31
Submitted: 2013-01-31
   Days after onset:87
Entered: 2013-01-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0384AE / 1 UN / UN

Administered by: Private       Purchased by: Public
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2012-11-05
   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: None
Current Illness: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data:
CDC Split Type: NH01320133

Write-up: MD visit at 1 week - healthy baby. 6 lbs 9 oz born at 39 weeks. ? SIDS death.


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