http://www.medalerts.org/vaersdb/fin...0&SORTING= ID
VAERS ID 297178 Vaccination Date: 2007-11-07
Age 2.0 Onset Date: 2007-11-10 Days later: 3
Sex F Submitted: 2007-11-16
State TX Entered: 2007-11-19
Life Threatening Illness? No
Died? Yes (date died: 2007-11-12)
Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Current Illness: NONE
Diagnostic Lab Data: Electrolytes with mild dehydrate. Histology shows
acute gastroenteritis and broncho-pneumonia
Previous Vaccinations:
Other Medications: NONE
Preexisting Conditions: PRE-MATURE BIRTH....NO COMPLICATIONS
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP SANOFI PASTEUR U2156AA 3 IM LL
HIBV SANOFI PASTEUR UF205AA 3 IM LL
IPV SANOFI PASTEUR Z0873 3 IM RL
MMR MERCK & CO. INC. 0706F 0 IM RL
PNC WYETH PHARMACEUTICALS, INC B08702H 3 IM RL
VARCEL MERCK & CO. INC. 06084 0 IM RL
Administered by: UNK Purchased by: UNK
Symptoms: Blood culture negative Bronchopneumonia Bronchopneumonia
Death Electrolyte imbalance Gastroenteritis Histology Pyrexia
Child started with high fever, 48 C, post vaccination and died on
11/12/2007