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This is VAERS ID 116569

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 116569
VAERS Form:
Age:1.4
Sex:Female
Location:Foreign
Vaccinated:1998-11-09
Onset:1998-11-09
Submitted:1998-11-17
Entered:1998-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 111011A / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Cardiac arrest, Cardiac failure, Cardiovascular disorder

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: unk
Current Illness:
Preexisting Conditions: aortic valve stenosis
Allergies:
Diagnostic Lab Data: unk
CDC 'Split Type': WAES98110919

Write-up: pt recv vax 9NOV98 & 3hr post vax pt exp sudden death;DOC unk;


Changed on 5/14/2017

VAERS ID: 116569 Before After
VAERS Form:
Age:1.4
Sex:Female
Location:Foreign
Vaccinated:1998-11-09
Onset:1998-11-09
Submitted:1998-11-17
Entered:1998-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 111011A / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Cardiac arrest, Cardiac failure, Cardiovascular disorder

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: unk
Current Illness:
Preexisting Conditions: aortic valve stenosis
Allergies:
Diagnostic Lab Data: unk
CDC 'Split Type': WAES98110919

Write-up: pt recv vax 9NOV98 & 3hr post vax pt exp sudden death;DOC unk;


Changed on 9/14/2017

VAERS ID: 116569 Before After
VAERS Form:(blank) 1
Age:1.4
Sex:Female
Location:Foreign
Vaccinated:1998-11-09
Onset:1998-11-09
Submitted:1998-11-17
Entered:1998-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 111011A / - UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Cardiac arrest, Cardiac failure, Cardiovascular disorder

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: unk
Current Illness:
Preexisting Conditions: aortic valve stenosis
Allergies:
Diagnostic Lab Data: unk
CDC 'Split Type': WAES98110919

Write-up: pt recv vax 9NOV98 & 3hr post vax pt exp sudden death;DOC unk;


Changed on 2/14/2018

VAERS ID: 116569 Before After
VAERS Form:1
Age:1.4
Sex:Female
Location:Foreign
Vaccinated:1998-11-09
Onset:1998-11-09
Submitted:1998-11-17
Entered:1998-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 111011A / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Cardiac arrest, Cardiac failure, Cardiovascular disorder

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: unk
Current Illness:
Preexisting Conditions: aortic valve stenosis
Allergies:
Diagnostic Lab Data: unk
CDC 'Split Type': WAES98110919

Write-up: pt recv vax 9NOV98 & 3hr post vax pt exp sudden death;DOC unk;


Changed on 6/14/2018

VAERS ID: 116569 Before After
VAERS Form:1
Age:1.4
Sex:Female
Location:Foreign
Vaccinated:1998-11-09
Onset:1998-11-09
Submitted:1998-11-17
Entered:1998-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 111011A / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Cardiac arrest, Cardiac failure, Cardiovascular disorder

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: unk
Current Illness:
Preexisting Conditions: aortic valve stenosis
Allergies:
Diagnostic Lab Data: unk
CDC 'Split Type': WAES98110919

Write-up: pt recv vax 9NOV98 & 3hr post vax pt exp sudden death;DOC unk;


Changed on 8/14/2018

VAERS ID: 116569 Before After
VAERS Form:1
Age:1.4
Sex:Female
Location:Foreign
Vaccinated:1998-11-09
Onset:1998-11-09
Submitted:1998-11-17
Entered:1998-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 111011A / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Cardiac arrest, Cardiac failure, Cardiovascular disorder

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: unk
Current Illness:
Preexisting Conditions: aortic valve stenosis
Allergies:
Diagnostic Lab Data: unk
CDC 'Split Type': WAES98110919

Write-up: pt recv vax 9NOV98 & 3hr post vax pt exp sudden death;DOC unk;


Changed on 9/14/2018

VAERS ID: 116569 Before After
VAERS Form:1
Age:1.4
Sex:Female
Location:Foreign
Vaccinated:1998-11-09
Onset:1998-11-09
Submitted:1998-11-17
Entered:1998-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 111011A / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Cardiac arrest, Cardiac failure, Cardiovascular disorder

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: unk
Current Illness:
Preexisting Conditions: aortic valve stenosis
Allergies:
Diagnostic Lab Data: unk
CDC 'Split Type': WAES98110919

Write-up: pt recv vax 9NOV98 & 3hr post vax pt exp sudden death;DOC unk;


Changed on 10/14/2018

VAERS ID: 116569 Before After
VAERS Form:1
Age:1.4
Sex:Female
Location:Foreign
Vaccinated:1998-11-09
Onset:1998-11-09
Submitted:1998-11-17
Entered:1998-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 111011A / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Cardiac arrest, Cardiac failure, Cardiovascular disorder

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: unk
Current Illness:
Preexisting Conditions: aortic valve stenosis
Allergies:
Diagnostic Lab Data: unk
CDC 'Split Type': WAES98110919

Write-up: pt recv vax 9NOV98 & 3hr post vax pt exp sudden death;DOC unk;

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