National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 116616

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 116616
VAERS Form:
Age:1.2
Sex:Male
Location:Vermont
Vaccinated:1998-10-07
Onset:1998-10-16
Submitted:1998-11-16
Entered:1998-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II / MSD 0785H / 0 RL / -
VARCEL: VARIVAX / MSD 0644H / 0 LL / -

Administered by: Private      Purchased by: Unknown
Symptoms: CONVULS, EDEMA LUNG, HYPOXIA, HYDRONEPHROSIS, EFFUS PERICARD

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-10-16
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: Ibuprofen
Current Illness: NONE
Preexisting Conditions: adopted child-birth parents siblings;hydronephrosis & renal insuff on autopsy
Allergies:
Diagnostic Lab Data: autopsy unrevealing of COD
CDC 'Split Type':

Write-up: unexplained infant death;autopsy finding of hydronephrosis & renal insufficiency not felt to be r/t pt death;


Changed on 12/8/2009

VAERS ID: 116616 Before After
VAERS Form:
Age:1.2
Sex:Male
Location:Vermont
Vaccinated:1998-10-07
Onset:1998-10-16
Submitted:1998-11-16
Entered:1998-11-25 1998-11-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 0785H / 0 RL / -
VARCEL: VARIVAX VARICELLA (VARIVAX) / MSD MERCK & CO. INC. 0644H / 0 LL / -

Administered by: Private      Purchased by: Unknown Public
Symptoms: Convulsion, Hydronephrosis, Hypoxia, Pericardial effusion, Pulmonary oedema, Rhinitis, Renal impairment, CONVULS, EDEMA LUNG, HYPOXIA, HYDRONEPHROSIS, EFFUS PERICARD

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-10-16
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: Ibuprofen
Current Illness: NONE
Preexisting Conditions: adopted child-birth parents siblings;hydronephrosis & renal insuff on autopsy
Allergies:
Diagnostic Lab Data: autopsy unrevealing of COD
CDC 'Split Type':

Write-up: unexplained infant death;autopsy finding of hydronephrosis & renal insufficiency not felt to be r/t pt death;


Changed on 5/14/2017

VAERS ID: 116616 Before After
VAERS Form:
Age:1.2
Sex:Male
Location:Vermont
Vaccinated:1998-10-07
Onset:1998-10-16
Submitted:1998-11-16
Entered:1998-11-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0785H / 0 RL / -
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0644H / 0 LL / -

Administered by: Private      Purchased by: Public
Symptoms: Convulsion, Hydronephrosis, Hypoxia, Pericardial effusion, Pulmonary oedema, Rhinitis, Renal impairment

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-10-16
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: Ibuprofen
Current Illness: NONE
Preexisting Conditions: adopted child-birth parents siblings;hydronephrosis & renal insuff on autopsy
Allergies:
Diagnostic Lab Data: autopsy unrevealing of COD
CDC 'Split Type':

Write-up: unexplained infant death;autopsy finding of hydronephrosis & renal insufficiency not felt to be r/t pt death;


Changed on 9/14/2017

VAERS ID: 116616 Before After
VAERS Form:(blank) 1
Age:1.2
Sex:Male
Location:Vermont
Vaccinated:1998-10-07
Onset:1998-10-16
Submitted:1998-11-16
Entered:1998-11-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0785H / 0 1 RL / -
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0644H / 0 1 LL / -

Administered by: Private      Purchased by: Public
Symptoms: Convulsion, Hydronephrosis, Hypoxia, Pericardial effusion, Pulmonary oedema, Rhinitis, Renal impairment

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-10-16
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: Ibuprofen
Current Illness: NONE
Preexisting Conditions: adopted child-birth parents siblings;hydronephrosis & renal insuff on autopsy
Allergies:
Diagnostic Lab Data: autopsy unrevealing of COD
CDC 'Split Type':

Write-up: unexplained infant death;autopsy finding of hydronephrosis & renal insufficiency not felt to be r/t pt death;


Changed on 2/14/2018

VAERS ID: 116616 Before After
VAERS Form:1
Age:1.2
Sex:Male
Location:Vermont
Vaccinated:1998-10-07
Onset:1998-10-16
Submitted:1998-11-16
Entered:1998-11-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0785H / 1 RL / -
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0644H / 1 LL / -

Administered by: Private      Purchased by: Public
Symptoms: Convulsion, Hydronephrosis, Hypoxia, Pericardial effusion, Pulmonary oedema, Rhinitis, Renal impairment

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-10-16
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: Ibuprofen
Current Illness: NONE
Preexisting Conditions: adopted child-birth parents siblings;hydronephrosis & renal insuff on autopsy
Allergies:
Diagnostic Lab Data: autopsy unrevealing of COD
CDC 'Split Type':

Write-up: unexplained infant death;autopsy finding of hydronephrosis & renal insufficiency not felt to be r/t pt death;


Changed on 6/14/2018

VAERS ID: 116616 Before After
VAERS Form:1
Age:1.2
Sex:Male
Location:Vermont
Vaccinated:1998-10-07
Onset:1998-10-16
Submitted:1998-11-16
Entered:1998-11-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0785H / 1 RL / -
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0644H / 1 LL / -

Administered by: Private      Purchased by: Public
Symptoms: Convulsion, Hydronephrosis, Hypoxia, Pericardial effusion, Pulmonary oedema, Rhinitis, Renal impairment

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-10-16
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: Ibuprofen
Current Illness: NONE
Preexisting Conditions: adopted child-birth parents siblings;hydronephrosis & renal insuff on autopsy
Allergies:
Diagnostic Lab Data: autopsy unrevealing of COD
CDC 'Split Type':

Write-up: unexplained infant death;autopsy finding of hydronephrosis & renal insufficiency not felt to be r/t pt death;


Changed on 8/14/2018

VAERS ID: 116616 Before After
VAERS Form:1
Age:1.2
Sex:Male
Location:Vermont
Vaccinated:1998-10-07
Onset:1998-10-16
Submitted:1998-11-16
Entered:1998-11-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0785H / 1 RL / -
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0644H / 1 LL / -

Administered by: Private      Purchased by: Public
Symptoms: Convulsion, Hydronephrosis, Hypoxia, Pericardial effusion, Pulmonary oedema, Rhinitis, Renal impairment

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-10-16
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: Ibuprofen
Current Illness: NONE
Preexisting Conditions: adopted child-birth parents siblings;hydronephrosis & renal insuff on autopsy
Allergies:
Diagnostic Lab Data: autopsy unrevealing of COD
CDC 'Split Type':

Write-up: unexplained infant death;autopsy finding of hydronephrosis & renal insufficiency not felt to be r/t pt death;


Changed on 9/14/2018

VAERS ID: 116616 Before After
VAERS Form:1
Age:1.2
Sex:Male
Location:Vermont
Vaccinated:1998-10-07
Onset:1998-10-16
Submitted:1998-11-16
Entered:1998-11-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0785H / 1 RL / -
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0644H / 1 LL / -

Administered by: Private      Purchased by: Public
Symptoms: Convulsion, Hydronephrosis, Hypoxia, Pericardial effusion, Pulmonary oedema, Rhinitis, Renal impairment

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-10-16
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: Ibuprofen
Current Illness: NONE
Preexisting Conditions: adopted child-birth parents siblings;hydronephrosis & renal insuff on autopsy
Allergies:
Diagnostic Lab Data: autopsy unrevealing of COD
CDC 'Split Type':

Write-up: unexplained infant death;autopsy finding of hydronephrosis & renal insufficiency not felt to be r/t pt death;


Changed on 10/14/2018

VAERS ID: 116616 Before After
VAERS Form:1
Age:1.2
Sex:Male
Location:Vermont
Vaccinated:1998-10-07
Onset:1998-10-16
Submitted:1998-11-16
Entered:1998-11-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0785H / 1 RL / -
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0644H / 1 LL / -

Administered by: Private      Purchased by: Public
Symptoms: Convulsion, Hydronephrosis, Hypoxia, Pericardial effusion, Pulmonary oedema, Rhinitis, Renal impairment

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-10-16
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: Ibuprofen
Current Illness: NONE
Preexisting Conditions: adopted child-birth parents siblings;hydronephrosis & renal insuff on autopsy
Allergies:
Diagnostic Lab Data: autopsy unrevealing of COD
CDC 'Split Type':

Write-up: unexplained infant death;autopsy finding of hydronephrosis & renal insufficiency not felt to be r/t pt death;

New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=116616&WAYBACKHISTORY=ON


Copyright © 2019 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166