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This is VAERS ID 126855

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 126855
VAERS Form:
Age:1.2
Sex:Female
Location:Mississippi
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1999-07-29
Entered:1999-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II / MSD - / - - / -
VARCEL: VARIVAX / MSD - / - - / -

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

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? No
Previous Vaccinations: no relevant data
Other Medications:
Current Illness:
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': unk

Write-up: rpt from anonymous person concerning pt who was vax & exp slight fever, tx w/tylenol; pt found dead next morning; COD unk; the rpt stated info was recv as ""hearsay'''' through small town grapevine & cannot be verified.


Changed on 12/8/2009

VAERS ID: 126855 Before After
VAERS Form:
Age:1.2
Sex:Female
Location:Mississippi
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1999-07-29
Entered:1999-08-05 1999-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. - / - - / -
VARCEL: VARIVAX VARICELLA (VARIVAX) / MSD MERCK & CO. INC. - / - - / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Apnoea, Cardiac arrest, Pyrexia, FEVER, APNEA, HEART ARREST

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? No
Previous Vaccinations: no relevant data
Other Medications:
Current Illness:
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': unk WAES99071550

Write-up: rpt from anonymous person concerning pt who was vax & exp slight fever, tx w/tylenol; pt found dead next morning; COD unk; the rpt stated info was recv as ""hearsay'''' "hearsay'''' through small town grapevine & cannot be verified.


Changed on 5/14/2017

VAERS ID: 126855 Before After
VAERS Form:
Age:1.2
Sex:Female
Location:Mississippi
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1999-07-29
Entered:1999-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / - - / -
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / - - / -

Administered by: Other      Purchased by: Other
Symptoms: Apnoea, Cardiac arrest, Pyrexia

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? No
Previous Vaccinations: no relevant data data~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES99071550

Write-up: rpt from anonymous person concerning pt who was vax & exp slight fever, tx w/tylenol; pt found dead next morning; COD unk; the rpt stated info was recv as "hearsay'''' through small town grapevine & cannot be verified.


Changed on 9/14/2017

VAERS ID: 126855 Before After
VAERS Form:(blank) 1
Age:1.2
Sex:Female
Location:Mississippi
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1999-07-29
Entered:1999-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / - UNK - / -
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / - UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Apnoea, Cardiac arrest, Pyrexia

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? No
Previous Vaccinations: no relevant data~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES99071550

Write-up: rpt from anonymous person concerning pt who was vax & exp slight fever, tx w/tylenol; pt found dead next morning; COD unk; the rpt stated info was recv as "hearsay'''' through small town grapevine & cannot be verified.


Changed on 2/14/2018

VAERS ID: 126855 Before After
VAERS Form:1
Age:1.2
Sex:Female
Location:Mississippi
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1999-07-29
Entered:1999-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Apnoea, Cardiac arrest, Pyrexia

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? No
Previous Vaccinations: no relevant data~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES99071550

Write-up: rpt from anonymous person concerning pt who was vax & exp slight fever, tx w/tylenol; pt found dead next morning; COD unk; the rpt stated info was recv as "hearsay'''' through small town grapevine & cannot be verified.


Changed on 6/14/2018

VAERS ID: 126855 Before After
VAERS Form:1
Age:1.2
Sex:Female
Location:Mississippi
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1999-07-29
Entered:1999-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Apnoea, Cardiac arrest, Pyrexia

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? No
Previous Vaccinations: no relevant data~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES99071550

Write-up: rpt from anonymous person concerning pt who was vax & exp slight fever, tx w/tylenol; pt found dead next morning; COD unk; the rpt stated info was recv as "hearsay'''' through small town grapevine & cannot be verified.


Changed on 8/14/2018

VAERS ID: 126855 Before After
VAERS Form:1
Age:1.2
Sex:Female
Location:Mississippi
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1999-07-29
Entered:1999-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Apnoea, Cardiac arrest, Pyrexia

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? No
Previous Vaccinations: no relevant data~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES99071550

Write-up: rpt from anonymous person concerning pt who was vax & exp slight fever, tx w/tylenol; pt found dead next morning; COD unk; the rpt stated info was recv as "hearsay'''' through small town grapevine & cannot be verified.


Changed on 9/14/2018

VAERS ID: 126855 Before After
VAERS Form:1
Age:1.2
Sex:Female
Location:Mississippi
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1999-07-29
Entered:1999-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Apnoea, Cardiac arrest, Pyrexia

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? No
Previous Vaccinations: no relevant data~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES99071550

Write-up: rpt from anonymous person concerning pt who was vax & exp slight fever, tx w/tylenol; pt found dead next morning; COD unk; the rpt stated info was recv as "hearsay'''' through small town grapevine & cannot be verified.


Changed on 10/14/2018

VAERS ID: 126855 Before After
VAERS Form:1
Age:1.2
Sex:Female
Location:Mississippi
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1999-07-29
Entered:1999-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Apnoea, Cardiac arrest, Pyrexia

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? No
Previous Vaccinations: no relevant data~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES99071550

Write-up: rpt from anonymous person concerning pt who was vax & exp slight fever, tx w/tylenol; pt found dead next morning; COD unk; the rpt stated info was recv as "hearsay'''' through small town grapevine & cannot be verified.

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=126855&WAYBACKHISTORY=ON


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