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This is VAERS ID 124936

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 124936
VAERS Form:
Age:1.0
Sex:Female
Location:Georgia
Vaccinated:1999-05-24
Onset:1999-06-01
Submitted:1999-06-15
Entered:1999-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II / MSD 1357H / 0 RA / SC
OPV: ORIMUNE / LEDERLE 0798D / 2 - / PO

Administered by: Public      Purchased by: Unknown
Symptoms: APNEA, CONVULS GRAND MAL, EDEMA LUNG, COAGUL DIS, EDEMA BRAIN

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1999-06-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 6/1/99, 1:30pm laid down for nap as usual; woke up at 4:05 w/ fever & seizures; called EMS; to hosp by ambulance still having seizures; died at 6:58pm; according to papers from the health dept severe rxn from MMR will happen w/ fever, sz


Changed on 12/8/2009

VAERS ID: 124936 Before After
VAERS Form:
Age:1.0
Sex:Female
Location:Georgia
Vaccinated:1999-05-24
Onset:1999-06-01
Submitted:1999-06-15
Entered:1999-06-21 1999-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 1357H / 0 RA / SC
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES 0798D / 2 - / PO

Administered by: Public      Purchased by: Unknown Public
Symptoms: Apnoea, Cardiac arrest, Coagulopathy, Febrile convulsion, Gastroenteritis, Gastrointestinal haemorrhage, Grand mal convulsion, Lung disorder, Pulmonary oedema, Vaginal haemorrhage, Vomiting, Brain oedema, APNEA, CONVULS GRAND MAL, EDEMA LUNG, COAGUL DIS, EDEMA BRAIN

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1999-06-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) WAES99060681

Write-up: 6/1/99, 1:30pm laid down for nap as usual; woke up at 4:05 w/ fever & seizures; called EMS; to hosp by ambulance still having seizures; died at 6:58pm; according to papers from the health dept severe rxn from MMR will happen w/ fever, sz


Changed on 5/14/2017

VAERS ID: 124936 Before After
VAERS Form:
Age:1.0
Sex:Female
Location:Georgia
Vaccinated:1999-05-24
Onset:1999-06-01
Submitted:1999-06-15
Entered:1999-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1357H / 0 RA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 0798D / 2 - / PO

Administered by: Public      Purchased by: Public
Symptoms: Apnoea, Cardiac arrest, Coagulopathy, Febrile convulsion, Gastroenteritis, Gastrointestinal haemorrhage, Grand mal convulsion, Lung disorder, Pulmonary oedema, Vaginal haemorrhage, Vomiting, Brain oedema

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1999-06-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: twin recv OPV same day & devel diarrhea (see #125065)~ ()~~~In Sibling
Other Medications: none NONE
Current Illness: none NONE
Preexisting Conditions: none NONE
Allergies:
Diagnostic Lab Data: 6/1/99 blood culture neg, CSF neg, metabolic screen for toxic substance neg, mean platelet vol 6.9 low,
CDC 'Split Type': WAES99060681

Write-up: 6/1/99, 1:30pm laid down for nap as usual; woke up at 4:05 w/ pt recv vax 5/24/99 & 6/1/99 pt was found to have a fever & seizures; called EMS; p/waking up from nap, had sz & was rushed to hosp by ambulance still having seizures; died at 6:58pm; according ER where was unable to papers from the health dept severe rxn from MMR will happen w/ fever, sz be resuscitated;COD @ time of reporting was unk;


Changed on 9/14/2017

VAERS ID: 124936 Before After
VAERS Form:(blank) 1
Age:1.0
Sex:Female
Location:Georgia
Vaccinated:1999-05-24
Onset:1999-06-01
Submitted:1999-06-15
Entered:1999-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1357H / 0 1 RA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0798D / 2 3 - MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Apnoea, Cardiac arrest, Coagulopathy, Febrile convulsion, Gastroenteritis, Gastrointestinal haemorrhage, Grand mal convulsion, Lung disorder, Pulmonary oedema, Vaginal haemorrhage, Vomiting, Brain oedema

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1999-06-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: twin recv OPV same day & devel diarrhea (see #125065)~ ()~~~In Sibling
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: 6/1/99 blood culture neg, CSF neg, metabolic screen for toxic substance neg, mean platelet vol 6.9 low,
CDC 'Split Type': WAES99060681

Write-up: pt recv vax 5/24/99 & 6/1/99 pt was found to have a fever & p/waking up from nap, had sz & was rushed to ER where was unable to be resuscitated;COD @ time of reporting was unk;


Changed on 2/14/2018

VAERS ID: 124936 Before After
VAERS Form:1
Age:1.0
Sex:Female
Location:Georgia
Vaccinated:1999-05-24
Onset:1999-06-01
Submitted:1999-06-15
Entered:1999-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1357H / 1 RA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0798D / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Apnoea, Cardiac arrest, Coagulopathy, Febrile convulsion, Gastroenteritis, Gastrointestinal haemorrhage, Grand mal convulsion, Lung disorder, Pulmonary oedema, Vaginal haemorrhage, Vomiting, Brain oedema

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1999-06-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: twin recv OPV same day & devel diarrhea (see #125065)~ ()~~~In Sibling
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: 6/1/99 blood culture neg, CSF neg, metabolic screen for toxic substance neg, mean platelet vol 6.9 low,
CDC 'Split Type': WAES99060681

Write-up: pt recv vax 5/24/99 & 6/1/99 pt was found to have a fever & p/waking up from nap, had sz & was rushed to ER where was unable to be resuscitated;COD @ time of reporting was unk;


Changed on 6/14/2018

VAERS ID: 124936 Before After
VAERS Form:1
Age:1.0
Sex:Female
Location:Georgia
Vaccinated:1999-05-24
Onset:1999-06-01
Submitted:1999-06-15
Entered:1999-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1357H / 1 RA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0798D / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Apnoea, Cardiac arrest, Coagulopathy, Febrile convulsion, Gastroenteritis, Gastrointestinal haemorrhage, Grand mal convulsion, Lung disorder, Pulmonary oedema, Vaginal haemorrhage, Vomiting, Brain oedema

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1999-06-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: twin recv OPV same day & devel diarrhea (see #125065)~ ()~~~In Sibling
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: 6/1/99 blood culture neg, CSF neg, metabolic screen for toxic substance neg, mean platelet vol 6.9 low,
CDC 'Split Type': WAES99060681

Write-up: pt recv vax 5/24/99 & 6/1/99 pt was found to have a fever & p/waking up from nap, had sz & was rushed to ER where was unable to be resuscitated;COD @ time of reporting was unk;


Changed on 8/14/2018

VAERS ID: 124936 Before After
VAERS Form:1
Age:1.0
Sex:Female
Location:Georgia
Vaccinated:1999-05-24
Onset:1999-06-01
Submitted:1999-06-15
Entered:1999-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1357H / 1 RA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0798D / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Apnoea, Cardiac arrest, Coagulopathy, Febrile convulsion, Gastroenteritis, Gastrointestinal haemorrhage, Grand mal convulsion, Lung disorder, Pulmonary oedema, Vaginal haemorrhage, Vomiting, Brain oedema

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1999-06-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: twin recv OPV same day & devel diarrhea (see #125065)~ ()~~~In Sibling
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: 6/1/99 blood culture neg, CSF neg, metabolic screen for toxic substance neg, mean platelet vol 6.9 low,
CDC 'Split Type': WAES99060681

Write-up: pt recv vax 5/24/99 & 6/1/99 pt was found to have a fever & p/waking up from nap, had sz & was rushed to ER where was unable to be resuscitated;COD @ time of reporting was unk;


Changed on 9/14/2018

VAERS ID: 124936 Before After
VAERS Form:1
Age:1.0
Sex:Female
Location:Georgia
Vaccinated:1999-05-24
Onset:1999-06-01
Submitted:1999-06-15
Entered:1999-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1357H / 1 RA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0798D / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Apnoea, Cardiac arrest, Coagulopathy, Febrile convulsion, Gastroenteritis, Gastrointestinal haemorrhage, Grand mal convulsion, Lung disorder, Pulmonary oedema, Vaginal haemorrhage, Vomiting, Brain oedema

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1999-06-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: twin recv OPV same day & devel diarrhea (see #125065)~ ()~~~In Sibling
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: 6/1/99 blood culture neg, CSF neg, metabolic screen for toxic substance neg, mean platelet vol 6.9 low,
CDC 'Split Type': WAES99060681

Write-up: pt recv vax 5/24/99 & 6/1/99 pt was found to have a fever & p/waking up from nap, had sz & was rushed to ER where was unable to be resuscitated;COD @ time of reporting was unk;


Changed on 10/14/2018

VAERS ID: 124936 Before After
VAERS Form:1
Age:1.0
Sex:Female
Location:Georgia
Vaccinated:1999-05-24
Onset:1999-06-01
Submitted:1999-06-15
Entered:1999-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1357H / 1 RA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0798D / 3 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Apnoea, Cardiac arrest, Coagulopathy, Febrile convulsion, Gastroenteritis, Gastrointestinal haemorrhage, Grand mal convulsion, Lung disorder, Pulmonary oedema, Vaginal haemorrhage, Vomiting, Brain oedema

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1999-06-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: twin recv OPV same day & devel diarrhea (see #125065)~ ()~~~In Sibling
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: 6/1/99 blood culture neg, CSF neg, metabolic screen for toxic substance neg, mean platelet vol 6.9 low,
CDC 'Split Type': WAES99060681

Write-up: pt recv vax 5/24/99 & 6/1/99 pt was found to have a fever & p/waking up from nap, had sz & was rushed to ER where was unable to be resuscitated;COD @ time of reporting was unk;

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