VAERS ID: 25028

AGE: 2| SEX: M|STATE: TN

Description

Pt admitted with H-Flu meningitis on 24Jun90. Pt expired on 25Jun90. Pt received HIB vaccine at 18 months of age.

Symptoms

Meningitis

Vaccines

VAX DATE: 05-24-1989| ONSET DATE: 06-24-1990| DAYS TO ONSET: 396
NameDose #TypeManufacturerLotRouteSite
HIB (PROHIBIT) Unknown HIBV CONNAUGHT LABORATORIES 8L01022 IM Unknown

RECVDATE:07-09-1990
RPT_DATE:
CAGE_YR:
CAGE_MO:
DIED:Y
DATEDIED:06-25-1990
L_THREAT:U
ER_VISIT:U
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:N
LAB_DATA:
V_ADMINBY:
OTHER_MEDS:
CUR_ILL:
HISTORY:
PRIOR_VAX:~ ()~~~In patient
SPLTTYPE:
FORM_VERS:1
TODAYS_DATE:
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:
V_FUNDBY:

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