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This is VAERS ID 114488

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 114488
VAERS Form:
Age:1.3
Sex:Female
Location:Foreign
Vaccinated:1998-09-09
Onset:1998-09-09
Submitted:1998-09-24
Entered:1998-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1000E / - - / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Acidosis, Agitation, Hypoxia, Pyrexia, Stupor, Sudden infant death syndrome, Syncope, Tachycardia, Unevaluable event

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1998-09-12
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? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: unk
Current Illness: unk
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data: autopsy-hypoxic encephalopathy following out of hosp cardiac arrest;
CDC 'Split Type': WAES98091172

Write-up: pt recv vax 9SEP98 & 6hr post vax pt parents found pt collapsed & unresponsive;pt adm to ICU & was ventilated for 3 days;12SEP98 pt died;pt COD sudden infant synd;


Changed on 5/14/2017

VAERS ID: 114488 Before After
VAERS Form:
Age:1.3
Sex:Female
Location:Foreign
Vaccinated:1998-09-09
Onset:1998-09-09
Submitted:1998-09-24
Entered:1998-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1000E / - - / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Acidosis, Agitation, Hypoxia, Pyrexia, Stupor, Sudden infant death syndrome, Syncope, Tachycardia, Unevaluable event

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1998-09-12
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? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness: unk
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data: autopsy-hypoxic encephalopathy following out of hosp cardiac arrest;
CDC 'Split Type': WAES98091172

Write-up: pt recv vax 9SEP98 & 6hr post vax pt parents found pt collapsed & unresponsive;pt adm to ICU & was ventilated for 3 days;12SEP98 pt died;pt COD sudden infant synd;


Changed on 9/14/2017

VAERS ID: 114488 Before After
VAERS Form:(blank) 1
Age:1.3
Sex:Female
Location:Foreign
Vaccinated:1998-09-09
Onset:1998-09-09
Submitted:1998-09-24
Entered:1998-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1000E / - UNK - / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Acidosis, Agitation, Hypoxia, Pyrexia, Stupor, Sudden infant death syndrome, Syncope, Tachycardia, Unevaluable event

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1998-09-12
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? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness: unk
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data: autopsy-hypoxic encephalopathy following out of hosp cardiac arrest;
CDC 'Split Type': WAES98091172

Write-up: pt recv vax 9SEP98 & 6hr post vax pt parents found pt collapsed & unresponsive;pt adm to ICU & was ventilated for 3 days;12SEP98 pt died;pt COD sudden infant synd;


Changed on 2/14/2018

VAERS ID: 114488 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Foreign
Vaccinated:1998-09-09
Onset:1998-09-09
Submitted:1998-09-24
Entered:1998-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1000E / UNK - / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Acidosis, Agitation, Hypoxia, Pyrexia, Stupor, Sudden infant death syndrome, Syncope, Tachycardia, Unevaluable event

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1998-09-12
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? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness: unk
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data: autopsy-hypoxic encephalopathy following out of hosp cardiac arrest;
CDC 'Split Type': WAES98091172

Write-up: pt recv vax 9SEP98 & 6hr post vax pt parents found pt collapsed & unresponsive;pt adm to ICU & was ventilated for 3 days;12SEP98 pt died;pt COD sudden infant synd;


Changed on 6/14/2018

VAERS ID: 114488 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Foreign
Vaccinated:1998-09-09
Onset:1998-09-09
Submitted:1998-09-24
Entered:1998-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1000E / UNK - / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Acidosis, Agitation, Hypoxia, Pyrexia, Stupor, Sudden infant death syndrome, Syncope, Tachycardia, Unevaluable event

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1998-09-12
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? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness: unk
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data: autopsy-hypoxic encephalopathy following out of hosp cardiac arrest;
CDC 'Split Type': WAES98091172

Write-up: pt recv vax 9SEP98 & 6hr post vax pt parents found pt collapsed & unresponsive;pt adm to ICU & was ventilated for 3 days;12SEP98 pt died;pt COD sudden infant synd;


Changed on 8/14/2018

VAERS ID: 114488 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Foreign
Vaccinated:1998-09-09
Onset:1998-09-09
Submitted:1998-09-24
Entered:1998-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1000E / UNK - / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Acidosis, Agitation, Hypoxia, Pyrexia, Stupor, Sudden infant death syndrome, Syncope, Tachycardia, Unevaluable event

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1998-09-12
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? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness: unk
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data: autopsy-hypoxic encephalopathy following out of hosp cardiac arrest;
CDC 'Split Type': WAES98091172

Write-up: pt recv vax 9SEP98 & 6hr post vax pt parents found pt collapsed & unresponsive;pt adm to ICU & was ventilated for 3 days;12SEP98 pt died;pt COD sudden infant synd;


Changed on 9/14/2018

VAERS ID: 114488 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Foreign
Vaccinated:1998-09-09
Onset:1998-09-09
Submitted:1998-09-24
Entered:1998-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1000E / UNK - / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Acidosis, Agitation, Hypoxia, Pyrexia, Stupor, Sudden infant death syndrome, Syncope, Tachycardia, Unevaluable event

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1998-09-12
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? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness: unk
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data: autopsy-hypoxic encephalopathy following out of hosp cardiac arrest;
CDC 'Split Type': WAES98091172

Write-up: pt recv vax 9SEP98 & 6hr post vax pt parents found pt collapsed & unresponsive;pt adm to ICU & was ventilated for 3 days;12SEP98 pt died;pt COD sudden infant synd;


Changed on 10/14/2018

VAERS ID: 114488 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Foreign
Vaccinated:1998-09-09
Onset:1998-09-09
Submitted:1998-09-24
Entered:1998-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1000E / UNK - / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Acidosis, Agitation, Hypoxia, Pyrexia, Stupor, Sudden infant death syndrome, Syncope, Tachycardia, Unevaluable event

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1998-09-12
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? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness: unk
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data: autopsy-hypoxic encephalopathy following out of hosp cardiac arrest;
CDC 'Split Type': WAES98091172

Write-up: pt recv vax 9SEP98 & 6hr post vax pt parents found pt collapsed & unresponsive;pt adm to ICU & was ventilated for 3 days;12SEP98 pt died;pt COD sudden infant synd;

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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=114488&WAYBACKHISTORY=ON


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