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This is VAERS ID 101589

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 101589
VAERS Form:
Age:1.6
Sex:Female
Location:Foreign
Vaccinated:1996-05-02
Onset:1996-05-11
Submitted:1997-08-06
Entered:1997-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / - - / -
PER: PERTUSSIS (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Sudden infant death syndrome

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1996-05-11
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: no relevant history
Allergies:
Diagnostic Lab Data: autopsy fulfills all criteria for SIDS;
CDC 'Split Type': WAES97072078

Write-up: pt recv vax 2MAY96 & exp no immed rxn p/vax; 11MAY96 pt died;autopsy protocol states that apart from being too old pt fulfils all criteria for sudden infant death synd (SIDS);reporter felt that COD was not f/t therapy w/MMR;


Changed on 5/14/2017

VAERS ID: 101589 Before After
VAERS Form:
Age:1.6
Sex:Female
Location:Foreign
Vaccinated:1996-05-02
Onset:1996-05-11
Submitted:1997-08-06
Entered:1997-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / - - / -
PER: PERTUSSIS (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Sudden infant death syndrome

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1996-05-11
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions: no relevant history
Allergies:
Diagnostic Lab Data: autopsy fulfills all criteria for SIDS;
CDC 'Split Type': WAES97072078

Write-up: pt recv vax 2MAY96 & exp no immed rxn p/vax; 11MAY96 pt died;autopsy protocol states that apart from being too old pt fulfils all criteria for sudden infant death synd (SIDS);reporter felt that COD was not f/t therapy w/MMR;


Changed on 9/14/2017

VAERS ID: 101589 Before After
VAERS Form:(blank) 1
Age:1.6
Sex:Female
Location:Foreign
Vaccinated:1996-05-02
Onset:1996-05-11
Submitted:1997-08-06
Entered:1997-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / - UNK - / -
PER: PERTUSSIS (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Sudden infant death syndrome

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1996-05-11
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions: no relevant history
Allergies:
Diagnostic Lab Data: autopsy fulfills all criteria for SIDS;
CDC 'Split Type': WAES97072078

Write-up: pt recv vax 2MAY96 & exp no immed rxn p/vax; 11MAY96 pt died;autopsy protocol states that apart from being too old pt fulfils all criteria for sudden infant death synd (SIDS);reporter felt that COD was not f/t therapy w/MMR;


Changed on 2/14/2018

VAERS ID: 101589 Before After
VAERS Form:1
Age:1.6
Sex:Female
Location:Foreign
Vaccinated:1996-05-02
Onset:1996-05-11
Submitted:1997-08-06
Entered:1997-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -
PER: PERTUSSIS (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Sudden infant death syndrome

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1996-05-11
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions: no relevant history
Allergies:
Diagnostic Lab Data: autopsy fulfills all criteria for SIDS;
CDC 'Split Type': WAES97072078

Write-up: pt recv vax 2MAY96 & exp no immed rxn p/vax; 11MAY96 pt died;autopsy protocol states that apart from being too old pt fulfils all criteria for sudden infant death synd (SIDS);reporter felt that COD was not f/t therapy w/MMR;


Changed on 6/14/2018

VAERS ID: 101589 Before After
VAERS Form:1
Age:1.6
Sex:Female
Location:Foreign
Vaccinated:1996-05-02
Onset:1996-05-11
Submitted:1997-08-06
Entered:1997-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -
PER: PERTUSSIS (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Sudden infant death syndrome

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1996-05-11
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions: no relevant history
Allergies:
Diagnostic Lab Data: autopsy fulfills all criteria for SIDS;
CDC 'Split Type': WAES97072078

Write-up: pt recv vax 2MAY96 & exp no immed rxn p/vax; 11MAY96 pt died;autopsy protocol states that apart from being too old pt fulfils all criteria for sudden infant death synd (SIDS);reporter felt that COD was not f/t therapy w/MMR;


Changed on 8/14/2018

VAERS ID: 101589 Before After
VAERS Form:1
Age:1.6
Sex:Female
Location:Foreign
Vaccinated:1996-05-02
Onset:1996-05-11
Submitted:1997-08-06
Entered:1997-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -
PER: PERTUSSIS (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Sudden infant death syndrome

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1996-05-11
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions: no relevant history
Allergies:
Diagnostic Lab Data: autopsy fulfills all criteria for SIDS;
CDC 'Split Type': WAES97072078

Write-up: pt recv vax 2MAY96 & exp no immed rxn p/vax; 11MAY96 pt died;autopsy protocol states that apart from being too old pt fulfils all criteria for sudden infant death synd (SIDS);reporter felt that COD was not f/t therapy w/MMR;


Changed on 9/14/2018

VAERS ID: 101589 Before After
VAERS Form:1
Age:1.6
Sex:Female
Location:Foreign
Vaccinated:1996-05-02
Onset:1996-05-11
Submitted:1997-08-06
Entered:1997-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -
PER: PERTUSSIS (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Sudden infant death syndrome

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1996-05-11
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions: no relevant history
Allergies:
Diagnostic Lab Data: autopsy fulfills all criteria for SIDS;
CDC 'Split Type': WAES97072078

Write-up: pt recv vax 2MAY96 & exp no immed rxn p/vax; 11MAY96 pt died;autopsy protocol states that apart from being too old pt fulfils all criteria for sudden infant death synd (SIDS);reporter felt that COD was not f/t therapy w/MMR;


Changed on 10/14/2018

VAERS ID: 101589 Before After
VAERS Form:1
Age:1.6
Sex:Female
Location:Foreign
Vaccinated:1996-05-02
Onset:1996-05-11
Submitted:1997-08-06
Entered:1997-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -
PER: PERTUSSIS (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Sudden infant death syndrome

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1996-05-11
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions: no relevant history
Allergies:
Diagnostic Lab Data: autopsy fulfills all criteria for SIDS;
CDC 'Split Type': WAES97072078

Write-up: pt recv vax 2MAY96 & exp no immed rxn p/vax; 11MAY96 pt died;autopsy protocol states that apart from being too old pt fulfils all criteria for sudden infant death synd (SIDS);reporter felt that COD was not f/t therapy w/MMR;

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=101589&WAYBACKHISTORY=ON


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