National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 116883

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 116883
VAERS Form:
Age:1.2
Sex:Female
Location:California
Vaccinated:1998-04-24
Onset:1998-04-28
Submitted:1998-11-02
Entered:1998-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: TRIPEDIA / CONNAUGHT LABS 0927950 / 0 - / IM
HIBV: PROHIBIT / CONNAUGHT LABS 0927950 / 0 - / IM
MMR: MMR II / MSD 0026H / 0 - / -

Administered by: Private      Purchased by: Unknown
Symptoms: CYANOSIS, BRADYCARDIA, EDEMA LUNG, DIARRHEA, DEHYDRAT

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-04-30
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: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: autopsy revealed dehydration w/moderate WBC''s in CSF;
CDC 'Split Type': NONE

Write-up: child devel gastroenteritis 4 days p/vax; probably unrelated-devel worsening emesis & diarrhea over 2 days;despite intervention, pt subsequently went into shock & was taken to ER blue & pulseless;


Changed on 12/8/2009

VAERS ID: 116883 Before After
VAERS Form:
Age:1.2
Sex:Female
Location:California
Vaccinated:1998-04-24
Onset:1998-04-28
Submitted:1998-11-02
Entered:1998-11-30 1998-11-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: TRIPEDIA DTAP (TRIPEDIA) / CONNAUGHT LABS CONNAUGHT LABORATORIES 0927950 / 0 - / IM
HIBV: PROHIBIT HIB (PROHIBIT) / CONNAUGHT LABS CONNAUGHT LABORATORIES 0927950 / 0 - / IM
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 0026H / 0 - / -

Administered by: Private      Purchased by: Unknown Private
Symptoms: Bradycardia, Cyanosis, Dehydration, Diarrhoea, Lung disorder, Pulmonary oedema, Shock, Vomiting, CYANOSIS, BRADYCARDIA, EDEMA LUNG, DIARRHEA, DEHYDRAT

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-04-30
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: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: autopsy revealed dehydration w/moderate WBC''s in CSF;
CDC 'Split Type': NONE (blank)

Write-up: child devel gastroenteritis 4 days p/vax; probably unrelated-devel worsening emesis & diarrhea over 2 days;despite intervention, pt subsequently went into shock & was taken to ER blue & pulseless;


Changed on 2/14/2017

VAERS ID: 116883 Before After
VAERS Form:
Age:1.2
Sex:Female
Location:California
Vaccinated:1998-04-24
Onset:1998-04-28
Submitted:1998-11-02
Entered:1998-11-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 0927950 / 0 - / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0927950 / 0 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0026H / 0 - / -

Administered by: Private      Purchased by: Private
Symptoms: Bradycardia, Cyanosis, Dehydration, Diarrhoea, Lung disorder, Pulmonary oedema, Shock, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-04-30
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: NONE NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: autopsy revealed dehydration w/moderate WBC''s in CSF;
CDC 'Split Type':

Write-up: child devel gastroenteritis 4 days p/vax; probably unrelated-devel worsening emesis & diarrhea over 2 days;despite intervention, pt subsequently went into shock & was taken to ER blue & pulseless;


Changed on 9/14/2017

VAERS ID: 116883 Before After
VAERS Form:(blank) 1
Age:1.2
Sex:Female
Location:California
Vaccinated:1998-04-24
Onset:1998-04-28
Submitted:1998-11-02
Entered:1998-11-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 0927950 / 0 1 - / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0927950 / 0 1 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0026H / 0 1 - / -

Administered by: Private      Purchased by: Private
Symptoms: Bradycardia, Cyanosis, Dehydration, Diarrhoea, Lung disorder, Pulmonary oedema, Shock, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-04-30
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: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: autopsy revealed dehydration w/moderate WBC''s in CSF;
CDC 'Split Type':

Write-up: child devel gastroenteritis 4 days p/vax; probably unrelated-devel worsening emesis & diarrhea over 2 days;despite intervention, pt subsequently went into shock & was taken to ER blue & pulseless;


Changed on 2/14/2018

VAERS ID: 116883 Before After
VAERS Form:1
Age:1.2
Sex:Female
Location:California
Vaccinated:1998-04-24
Onset:1998-04-28
Submitted:1998-11-02
Entered:1998-11-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 0927950 / 1 - / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0927950 / 1 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0026H / 1 - / -

Administered by: Private      Purchased by: Private
Symptoms: Bradycardia, Cyanosis, Dehydration, Diarrhoea, Lung disorder, Pulmonary oedema, Shock, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-04-30
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: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: autopsy revealed dehydration w/moderate WBC''s in CSF;
CDC 'Split Type':

Write-up: child devel gastroenteritis 4 days p/vax; probably unrelated-devel worsening emesis & diarrhea over 2 days;despite intervention, pt subsequently went into shock & was taken to ER blue & pulseless;


Changed on 6/14/2018

VAERS ID: 116883 Before After
VAERS Form:1
Age:1.2
Sex:Female
Location:California
Vaccinated:1998-04-24
Onset:1998-04-28
Submitted:1998-11-02
Entered:1998-11-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 0927950 / 1 - / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0927950 / 1 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0026H / 1 - / -

Administered by: Private      Purchased by: Private
Symptoms: Bradycardia, Cyanosis, Dehydration, Diarrhoea, Lung disorder, Pulmonary oedema, Shock, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-04-30
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: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: autopsy revealed dehydration w/moderate WBC''s in CSF;
CDC 'Split Type':

Write-up: child devel gastroenteritis 4 days p/vax; probably unrelated-devel worsening emesis & diarrhea over 2 days;despite intervention, pt subsequently went into shock & was taken to ER blue & pulseless;


Changed on 8/14/2018

VAERS ID: 116883 Before After
VAERS Form:1
Age:1.2
Sex:Female
Location:California
Vaccinated:1998-04-24
Onset:1998-04-28
Submitted:1998-11-02
Entered:1998-11-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 0927950 / 1 - / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0927950 / 1 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0026H / 1 - / -

Administered by: Private      Purchased by: Private
Symptoms: Bradycardia, Cyanosis, Dehydration, Diarrhoea, Lung disorder, Pulmonary oedema, Shock, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-04-30
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: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: autopsy revealed dehydration w/moderate WBC''s in CSF;
CDC 'Split Type':

Write-up: child devel gastroenteritis 4 days p/vax; probably unrelated-devel worsening emesis & diarrhea over 2 days;despite intervention, pt subsequently went into shock & was taken to ER blue & pulseless;


Changed on 9/14/2018

VAERS ID: 116883 Before After
VAERS Form:1
Age:1.2
Sex:Female
Location:California
Vaccinated:1998-04-24
Onset:1998-04-28
Submitted:1998-11-02
Entered:1998-11-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 0927950 / 1 - / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0927950 / 1 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0026H / 1 - / -

Administered by: Private      Purchased by: Private
Symptoms: Bradycardia, Cyanosis, Dehydration, Diarrhoea, Lung disorder, Pulmonary oedema, Shock, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-04-30
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: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: autopsy revealed dehydration w/moderate WBC''s in CSF;
CDC 'Split Type':

Write-up: child devel gastroenteritis 4 days p/vax; probably unrelated-devel worsening emesis & diarrhea over 2 days;despite intervention, pt subsequently went into shock & was taken to ER blue & pulseless;


Changed on 10/14/2018

VAERS ID: 116883 Before After
VAERS Form:1
Age:1.2
Sex:Female
Location:California
Vaccinated:1998-04-24
Onset:1998-04-28
Submitted:1998-11-02
Entered:1998-11-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 0927950 / 1 - / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0927950 / 1 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0026H / 1 - / -

Administered by: Private      Purchased by: Private
Symptoms: Bradycardia, Cyanosis, Dehydration, Diarrhoea, Lung disorder, Pulmonary oedema, Shock, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-04-30
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: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: autopsy revealed dehydration w/moderate WBC''s in CSF;
CDC 'Split Type':

Write-up: child devel gastroenteritis 4 days p/vax; probably unrelated-devel worsening emesis & diarrhea over 2 days;despite intervention, pt subsequently went into shock & was taken to ER blue & pulseless;

New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=116883&WAYBACKHISTORY=ON


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