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This is VAERS ID 123185

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 123185
VAERS Form:
Age:1.4
Sex:Female
Location:New York
Vaccinated:1995-02-10
Onset:1995-02-20
Submitted:1999-05-26
Entered:1999-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II / MSD - / 0 - / -

Administered by: Other      Purchased by: Unknown
Symptoms: FEVER, RASH, INFECT, ENCEPHALITIS, ANEMIA APLAST

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: roseola type virus,fever,rash p/ MMR #1
Other Medications: unk
Current Illness:
Preexisting Conditions: fever;viral exanthema;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': fever;viral exanthema;

Write-up: pt recv vax & became ill 10 days p/vax;pt had a viral synd which devel into encephalitis & was hosp;pt then devel aplastic anemia & dx w/Dubowitz synd;pt had recurrence of aplastic anemia;pt died


Changed on 12/8/2009

VAERS ID: 123185 Before After
VAERS Form:
Age:1.4
Sex:Female
Location:New York
Vaccinated:1995-02-10
Onset:1995-02-20
Submitted:1999-05-26
Entered:1999-06-02 1999-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. - / 0 - / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Aplastic anaemia, Encephalitis, Infection, Pyrexia, Rash, FEVER, RASH, INFECT, ENCEPHALITIS, ANEMIA APLAST

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: roseola type virus,fever,rash p/ MMR #1
Other Medications: unk
Current Illness:
Preexisting Conditions: fever;viral exanthema;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': fever;viral exanthema; WAES99051409

Write-up: pt recv vax & became ill 10 days p/vax;pt had a viral synd which devel into encephalitis & was hosp;pt then devel aplastic anemia & dx w/Dubowitz synd;pt had recurrence of aplastic anemia;pt died


Changed on 5/14/2017

VAERS ID: 123185 Before After
VAERS Form:
Age:1.4
Sex:Female
Location:New York
Vaccinated:1995-02-10
Onset:1995-02-20
Submitted:1999-05-26
Entered:1999-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 0 - / -

Administered by: Other      Purchased by: Other
Symptoms: Aplastic anaemia, Encephalitis, Infection, Pyrexia, Rash

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: roseola type virus,fever,rash p/ MMR #1 #1~ ()~~~In patient
Other Medications: unk
Current Illness:
Preexisting Conditions: fever;viral exanthema;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES99051409

Write-up: pt recv vax & became ill 10 days p/vax;pt had a viral synd which devel into encephalitis & was hosp;pt then devel aplastic anemia & dx w/Dubowitz synd;pt had recurrence of aplastic anemia;pt died


Changed on 9/14/2017

VAERS ID: 123185 Before After
VAERS Form:(blank) 1
Age:1.4
Sex:Female
Location:New York
Vaccinated:1995-02-10
Onset:1995-02-20
Submitted:1999-05-26
Entered:1999-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 0 1 - / -

Administered by: Other      Purchased by: Other
Symptoms: Aplastic anaemia, Encephalitis, Infection, Pyrexia, Rash

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: roseola type virus,fever,rash p/ MMR #1~ ()~~~In patient
Other Medications: unk
Current Illness:
Preexisting Conditions: fever;viral exanthema;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES99051409

Write-up: pt recv vax & became ill 10 days p/vax;pt had a viral synd which devel into encephalitis & was hosp;pt then devel aplastic anemia & dx w/Dubowitz synd;pt had recurrence of aplastic anemia;pt died


Changed on 2/14/2018

VAERS ID: 123185 Before After
VAERS Form:1
Age:1.4
Sex:Female
Location:New York
Vaccinated:1995-02-10
Onset:1995-02-20
Submitted:1999-05-26
Entered:1999-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 1 - / -

Administered by: Other      Purchased by: Other
Symptoms: Aplastic anaemia, Encephalitis, Infection, Pyrexia, Rash

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: roseola type virus,fever,rash p/ MMR #1~ ()~~~In patient
Other Medications: unk
Current Illness:
Preexisting Conditions: fever;viral exanthema;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES99051409

Write-up: pt recv vax & became ill 10 days p/vax;pt had a viral synd which devel into encephalitis & was hosp;pt then devel aplastic anemia & dx w/Dubowitz synd;pt had recurrence of aplastic anemia;pt died


Changed on 6/14/2018

VAERS ID: 123185 Before After
VAERS Form:1
Age:1.4
Sex:Female
Location:New York
Vaccinated:1995-02-10
Onset:1995-02-20
Submitted:1999-05-26
Entered:1999-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 1 - / -

Administered by: Other      Purchased by: Other
Symptoms: Aplastic anaemia, Encephalitis, Infection, Pyrexia, Rash

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: roseola type virus,fever,rash p/ MMR #1~ ()~~~In patient
Other Medications: unk
Current Illness:
Preexisting Conditions: fever;viral exanthema;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES99051409

Write-up: pt recv vax & became ill 10 days p/vax;pt had a viral synd which devel into encephalitis & was hosp;pt then devel aplastic anemia & dx w/Dubowitz synd;pt had recurrence of aplastic anemia;pt died


Changed on 8/14/2018

VAERS ID: 123185 Before After
VAERS Form:1
Age:1.4
Sex:Female
Location:New York
Vaccinated:1995-02-10
Onset:1995-02-20
Submitted:1999-05-26
Entered:1999-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 1 - / -

Administered by: Other      Purchased by: Other
Symptoms: Aplastic anaemia, Encephalitis, Infection, Pyrexia, Rash

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: roseola type virus,fever,rash p/ MMR #1~ ()~~~In patient
Other Medications: unk
Current Illness:
Preexisting Conditions: fever;viral exanthema;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES99051409

Write-up: pt recv vax & became ill 10 days p/vax;pt had a viral synd which devel into encephalitis & was hosp;pt then devel aplastic anemia & dx w/Dubowitz synd;pt had recurrence of aplastic anemia;pt died


Changed on 9/14/2018

VAERS ID: 123185 Before After
VAERS Form:1
Age:1.4
Sex:Female
Location:New York
Vaccinated:1995-02-10
Onset:1995-02-20
Submitted:1999-05-26
Entered:1999-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 1 - / -

Administered by: Other      Purchased by: Other
Symptoms: Aplastic anaemia, Encephalitis, Infection, Pyrexia, Rash

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: roseola type virus,fever,rash p/ MMR #1~ ()~~~In patient
Other Medications: unk
Current Illness:
Preexisting Conditions: fever;viral exanthema;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES99051409

Write-up: pt recv vax & became ill 10 days p/vax;pt had a viral synd which devel into encephalitis & was hosp;pt then devel aplastic anemia & dx w/Dubowitz synd;pt had recurrence of aplastic anemia;pt died


Changed on 10/14/2018

VAERS ID: 123185 Before After
VAERS Form:1
Age:1.4
Sex:Female
Location:New York
Vaccinated:1995-02-10
Onset:1995-02-20
Submitted:1999-05-26
Entered:1999-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 1 - / -

Administered by: Other      Purchased by: Other
Symptoms: Aplastic anaemia, Encephalitis, Infection, Pyrexia, Rash

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: roseola type virus,fever,rash p/ MMR #1~ ()~~~In patient
Other Medications: unk
Current Illness:
Preexisting Conditions: fever;viral exanthema;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES99051409

Write-up: pt recv vax & became ill 10 days p/vax;pt had a viral synd which devel into encephalitis & was hosp;pt then devel aplastic anemia & dx w/Dubowitz synd;pt had recurrence of aplastic anemia;pt died

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=123185&WAYBACKHISTORY=ON


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