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This is VAERS ID 122669

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 122669
VAERS Form:
Age:1.3
Sex:Male
Location:Unknown
Vaccinated:1999-04-26
Onset:1999-04-28
Submitted:1999-05-20
Entered:1999-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: UNK. HAEMOPHILUS B / UNCLASSIFIED - / 3 - / -
MMR: MMR II / MSD - / - - / -

Administered by: Other      Purchased by: Unknown
Symptoms: AGITATION, FEVER, APNEA, HEART ARREST, ECCHYMOSIS

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1999-05-02
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: No relevant data;
Other Medications:
Current Illness:
Preexisting Conditions: lt hip dysplasia;otic infection;seizure
Allergies:
Diagnostic Lab Data: bacterial cult (blood/spleen/brain/lungs)=neg;xrays=nl; child had small bruise on head from fall-no evidence of trauma; viral cult (brain/lung/intestine) not avail
CDC 'Split Type': lt hip dysplasia;otic infection;seizure

Write-up: mo put sunscreen on face day of vax;2 days p/ vax little red dots on upper cheeks, not itchy & T99.3-99.5(ear);4th and 5th day p/ vax, afebrile but out of sorts & wanting to be held more; AM-6th day found dead in bed, COD SIDS, autopsy neg.


Changed on 12/8/2009

VAERS ID: 122669 Before After
VAERS Form:
Age:1.3
Sex:Male
Location:Unknown
Vaccinated:1999-04-26
Onset:1999-04-28
Submitted:1999-05-20
Entered:1999-05-26 1999-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: UNK. HAEMOPHILUS B HIB (NO BRAND NAME) / UNCLASSIFIED UNKNOWN MANUFACTURER - / 3 - / -
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. - / - - / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Agitation, Apnoea, Cardiac arrest, Ecchymosis, Pyrexia, Rash, Sudden infant death syndrome, AGITATION, FEVER, APNEA, HEART ARREST, ECCHYMOSIS

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1999-05-02
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: No relevant data;
Other Medications:
Current Illness:
Preexisting Conditions: lt hip dysplasia;otic infection;seizure
Allergies:
Diagnostic Lab Data: bacterial cult (blood/spleen/brain/lungs)=neg;xrays=nl; child had small bruise on head from fall-no evidence of trauma; viral cult (brain/lung/intestine) not avail
CDC 'Split Type': lt hip dysplasia;otic infection;seizure WAES99050142

Write-up: mo put sunscreen on face day of vax;2 days p/ vax little red dots on upper cheeks, not itchy & T99.3-99.5(ear);4th and 5th day p/ vax, afebrile but out of sorts & wanting to be held more; AM-6th day found dead in bed, COD SIDS, autopsy neg.


Changed on 5/14/2017

VAERS ID: 122669 Before After
VAERS Form:
Age:1.3
Sex:Male
Location:Unknown
Vaccinated:1999-04-26
Onset:1999-04-28
Submitted:1999-05-20
Entered:1999-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 3 - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / - - / -

Administered by: Other      Purchased by: Other
Symptoms: Agitation, Apnoea, Cardiac arrest, Ecchymosis, Pyrexia, Rash, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1999-05-02
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: No relevant data; data;~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: lt hip dysplasia;otic infection;seizure
Allergies:
Diagnostic Lab Data: bacterial cult (blood/spleen/brain/lungs)=neg;xrays=nl; child had small bruise on head from fall-no evidence of trauma; viral cult (brain/lung/intestine) not avail
CDC 'Split Type': WAES99050142

Write-up: mo put sunscreen on face day of vax;2 days p/ vax little red dots on upper cheeks, not itchy & T99.3-99.5(ear);4th and 5th day p/ vax, afebrile but out of sorts & wanting to be held more; AM-6th day found dead in bed, COD SIDS, autopsy neg.


Changed on 9/14/2017

VAERS ID: 122669 Before After
VAERS Form:(blank) 1
Age:1.3
Sex:Male
Location:Unknown
Vaccinated:1999-04-26
Onset:1999-04-28
Submitted:1999-05-20
Entered:1999-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 3 4 - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / - UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Agitation, Apnoea, Cardiac arrest, Ecchymosis, Pyrexia, Rash, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1999-05-02
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: No relevant data;~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: lt hip dysplasia;otic infection;seizure
Allergies:
Diagnostic Lab Data: bacterial cult (blood/spleen/brain/lungs)=neg;xrays=nl; child had small bruise on head from fall-no evidence of trauma; viral cult (brain/lung/intestine) not avail
CDC 'Split Type': WAES99050142

Write-up: mo put sunscreen on face day of vax;2 days p/ vax little red dots on upper cheeks, not itchy & T99.3-99.5(ear);4th and 5th day p/ vax, afebrile but out of sorts & wanting to be held more; AM-6th day found dead in bed, COD SIDS, autopsy neg.


Changed on 2/14/2018

VAERS ID: 122669 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:Unknown
Vaccinated:1999-04-26
Onset:1999-04-28
Submitted:1999-05-20
Entered:1999-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 4 - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Agitation, Apnoea, Cardiac arrest, Ecchymosis, Pyrexia, Rash, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1999-05-02
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: No relevant data;~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: lt hip dysplasia;otic infection;seizure
Allergies:
Diagnostic Lab Data: bacterial cult (blood/spleen/brain/lungs)=neg;xrays=nl; child had small bruise on head from fall-no evidence of trauma; viral cult (brain/lung/intestine) not avail
CDC 'Split Type': WAES99050142

Write-up: mo put sunscreen on face day of vax;2 days p/ vax little red dots on upper cheeks, not itchy & T99.3-99.5(ear);4th and 5th day p/ vax, afebrile but out of sorts & wanting to be held more; AM-6th day found dead in bed, COD SIDS, autopsy neg.


Changed on 6/14/2018

VAERS ID: 122669 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:Unknown
Vaccinated:1999-04-26
Onset:1999-04-28
Submitted:1999-05-20
Entered:1999-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 4 - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Agitation, Apnoea, Cardiac arrest, Ecchymosis, Pyrexia, Rash, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1999-05-02
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: No relevant data;~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: lt hip dysplasia;otic infection;seizure
Allergies:
Diagnostic Lab Data: bacterial cult (blood/spleen/brain/lungs)=neg;xrays=nl; child had small bruise on head from fall-no evidence of trauma; viral cult (brain/lung/intestine) not avail
CDC 'Split Type': WAES99050142

Write-up: mo put sunscreen on face day of vax;2 days p/ vax little red dots on upper cheeks, not itchy & T99.3-99.5(ear);4th and 5th day p/ vax, afebrile but out of sorts & wanting to be held more; AM-6th day found dead in bed, COD SIDS, autopsy neg.


Changed on 8/14/2018

VAERS ID: 122669 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:Unknown
Vaccinated:1999-04-26
Onset:1999-04-28
Submitted:1999-05-20
Entered:1999-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 4 - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Agitation, Apnoea, Cardiac arrest, Ecchymosis, Pyrexia, Rash, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1999-05-02
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: No relevant data;~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: lt hip dysplasia;otic infection;seizure
Allergies:
Diagnostic Lab Data: bacterial cult (blood/spleen/brain/lungs)=neg;xrays=nl; child had small bruise on head from fall-no evidence of trauma; viral cult (brain/lung/intestine) not avail
CDC 'Split Type': WAES99050142

Write-up: mo put sunscreen on face day of vax;2 days p/ vax little red dots on upper cheeks, not itchy & T99.3-99.5(ear);4th and 5th day p/ vax, afebrile but out of sorts & wanting to be held more; AM-6th day found dead in bed, COD SIDS, autopsy neg.


Changed on 9/14/2018

VAERS ID: 122669 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:Unknown
Vaccinated:1999-04-26
Onset:1999-04-28
Submitted:1999-05-20
Entered:1999-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 4 - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Agitation, Apnoea, Cardiac arrest, Ecchymosis, Pyrexia, Rash, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1999-05-02
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: No relevant data;~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: lt hip dysplasia;otic infection;seizure
Allergies:
Diagnostic Lab Data: bacterial cult (blood/spleen/brain/lungs)=neg;xrays=nl; child had small bruise on head from fall-no evidence of trauma; viral cult (brain/lung/intestine) not avail
CDC 'Split Type': WAES99050142

Write-up: mo put sunscreen on face day of vax;2 days p/ vax little red dots on upper cheeks, not itchy & T99.3-99.5(ear);4th and 5th day p/ vax, afebrile but out of sorts & wanting to be held more; AM-6th day found dead in bed, COD SIDS, autopsy neg.


Changed on 10/14/2018

VAERS ID: 122669 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:Unknown
Vaccinated:1999-04-26
Onset:1999-04-28
Submitted:1999-05-20
Entered:1999-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 4 - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Agitation, Apnoea, Cardiac arrest, Ecchymosis, Pyrexia, Rash, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1999-05-02
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: No relevant data;~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: lt hip dysplasia;otic infection;seizure
Allergies:
Diagnostic Lab Data: bacterial cult (blood/spleen/brain/lungs)=neg;xrays=nl; child had small bruise on head from fall-no evidence of trauma; viral cult (brain/lung/intestine) not avail
CDC 'Split Type': WAES99050142

Write-up: mo put sunscreen on face day of vax;2 days p/ vax little red dots on upper cheeks, not itchy & T99.3-99.5(ear);4th and 5th day p/ vax, afebrile but out of sorts & wanting to be held more; AM-6th day found dead in bed, COD SIDS, autopsy neg.

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=122669&WAYBACKHISTORY=ON


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