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This is VAERS ID 131353

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 131353
VAERS Form:
Age:10.0
Sex:Male
Location:Foreign
Vaccinated:1999-10-21
Onset:1999-10-24
Submitted:1999-11-19
Entered:1999-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 1 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Cardiac arrest, Coma, Confusional state, Convulsion, Electroencephalogram abnormal, Encephalitis, Headache, Infection, Laboratory test abnormal, Meningitis, Nausea, Paraesthesia, Pyrexia, Somnolence, Nuchal rigidity, CSF test abnormal

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1999-11-04
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:
Other Medications:
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: 10/28/99 electroencephalography-severe cerebral distrubances;MRI intraparenchymatous lesions evoked dx of herpetic infect process;herpes;lyme negative;mycoplasm IG=12;10/30/99 electroenephalography-confirmed aggravation of cerebral lesions;
CDC 'Split Type': WAES99111051

Write-up: p/vax pt w/drowsiness & cephalagia;hosp & fever & tonic clonic convuls;no motor deficiency but paresthesia & meningism (nausea & neck stiffness);pt confused;to ICU exp cardiac & resp arrest;state IV coma;dx meningoencephalitis;pt died


Changed on 5/14/2017

VAERS ID: 131353 Before After
VAERS Form:
Age:10.0
Sex:Male
Location:Foreign
Vaccinated:1999-10-21
Onset:1999-10-24
Submitted:1999-11-19
Entered:1999-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 1 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Cardiac arrest, Coma, Confusional state, Convulsion, Electroencephalogram abnormal, Encephalitis, Headache, Infection, Laboratory test abnormal, Meningitis, Nausea, Paraesthesia, Pyrexia, Somnolence, Nuchal rigidity, CSF test abnormal

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1999-11-04
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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: 10/28/99 electroencephalography-severe cerebral distrubances;MRI intraparenchymatous lesions evoked dx of herpetic infect process;herpes;lyme negative;mycoplasm IG=12;10/30/99 electroenephalography-confirmed aggravation of cerebral lesions;
CDC 'Split Type': WAES99111051

Write-up: p/vax pt w/drowsiness & cephalagia;hosp & fever & tonic clonic convuls;no motor deficiency but paresthesia & meningism (nausea & neck stiffness);pt confused;to ICU exp cardiac & resp arrest;state IV coma;dx meningoencephalitis;pt died


Changed on 9/14/2017

VAERS ID: 131353 Before After
VAERS Form:(blank) 1
Age:10.0
Sex:Male
Location:Foreign
Vaccinated:1999-10-21
Onset:1999-10-24
Submitted:1999-11-19
Entered:1999-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 1 2 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Cardiac arrest, Coma, Confusional state, Convulsion, Electroencephalogram abnormal, Encephalitis, Headache, Infection, Laboratory test abnormal, Meningitis, Nausea, Paraesthesia, Pyrexia, Somnolence, Nuchal rigidity, CSF test abnormal

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1999-11-04
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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: 10/28/99 electroencephalography-severe cerebral distrubances;MRI intraparenchymatous lesions evoked dx of herpetic infect process;herpes;lyme negative;mycoplasm IG=12;10/30/99 electroenephalography-confirmed aggravation of cerebral lesions;
CDC 'Split Type': WAES99111051

Write-up: p/vax pt w/drowsiness & cephalagia;hosp & fever & tonic clonic convuls;no motor deficiency but paresthesia & meningism (nausea & neck stiffness);pt confused;to ICU exp cardiac & resp arrest;state IV coma;dx meningoencephalitis;pt died


Changed on 2/14/2018

VAERS ID: 131353 Before After
VAERS Form:1
Age:10.0
Sex:Male
Location:Foreign
Vaccinated:1999-10-21
Onset:1999-10-24
Submitted:1999-11-19
Entered:1999-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 2 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Cardiac arrest, Coma, Confusional state, Convulsion, Electroencephalogram abnormal, Encephalitis, Headache, Infection, Laboratory test abnormal, Meningitis, Nausea, Paraesthesia, Pyrexia, Somnolence, Nuchal rigidity, CSF test abnormal

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1999-11-04
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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: 10/28/99 electroencephalography-severe cerebral distrubances;MRI intraparenchymatous lesions evoked dx of herpetic infect process;herpes;lyme negative;mycoplasm IG=12;10/30/99 electroenephalography-confirmed aggravation of cerebral lesions;
CDC 'Split Type': WAES99111051

Write-up: p/vax pt w/drowsiness & cephalagia;hosp & fever & tonic clonic convuls;no motor deficiency but paresthesia & meningism (nausea & neck stiffness);pt confused;to ICU exp cardiac & resp arrest;state IV coma;dx meningoencephalitis;pt died


Changed on 6/14/2018

VAERS ID: 131353 Before After
VAERS Form:1
Age:10.0
Sex:Male
Location:Foreign
Vaccinated:1999-10-21
Onset:1999-10-24
Submitted:1999-11-19
Entered:1999-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 2 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Cardiac arrest, Coma, Confusional state, Convulsion, Electroencephalogram abnormal, Encephalitis, Headache, Infection, Laboratory test abnormal, Meningitis, Nausea, Paraesthesia, Pyrexia, Somnolence, Nuchal rigidity, CSF test abnormal

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1999-11-04
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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: 10/28/99 electroencephalography-severe cerebral distrubances;MRI intraparenchymatous lesions evoked dx of herpetic infect process;herpes;lyme negative;mycoplasm IG=12;10/30/99 electroenephalography-confirmed aggravation of cerebral lesions;
CDC 'Split Type': WAES99111051

Write-up: p/vax pt w/drowsiness & cephalagia;hosp & fever & tonic clonic convuls;no motor deficiency but paresthesia & meningism (nausea & neck stiffness);pt confused;to ICU exp cardiac & resp arrest;state IV coma;dx meningoencephalitis;pt died


Changed on 8/14/2018

VAERS ID: 131353 Before After
VAERS Form:1
Age:10.0
Sex:Male
Location:Foreign
Vaccinated:1999-10-21
Onset:1999-10-24
Submitted:1999-11-19
Entered:1999-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 2 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Cardiac arrest, Coma, Confusional state, Convulsion, Electroencephalogram abnormal, Encephalitis, Headache, Infection, Laboratory test abnormal, Meningitis, Nausea, Paraesthesia, Pyrexia, Somnolence, Nuchal rigidity, CSF test abnormal

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1999-11-04
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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: 10/28/99 electroencephalography-severe cerebral distrubances;MRI intraparenchymatous lesions evoked dx of herpetic infect process;herpes;lyme negative;mycoplasm IG=12;10/30/99 electroenephalography-confirmed aggravation of cerebral lesions;
CDC 'Split Type': WAES99111051

Write-up: p/vax pt w/drowsiness & cephalagia;hosp & fever & tonic clonic convuls;no motor deficiency but paresthesia & meningism (nausea & neck stiffness);pt confused;to ICU exp cardiac & resp arrest;state IV coma;dx meningoencephalitis;pt died


Changed on 9/14/2018

VAERS ID: 131353 Before After
VAERS Form:1
Age:10.0
Sex:Male
Location:Foreign
Vaccinated:1999-10-21
Onset:1999-10-24
Submitted:1999-11-19
Entered:1999-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 2 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Cardiac arrest, Coma, Confusional state, Convulsion, Electroencephalogram abnormal, Encephalitis, Headache, Infection, Laboratory test abnormal, Meningitis, Nausea, Paraesthesia, Pyrexia, Somnolence, Nuchal rigidity, CSF test abnormal

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1999-11-04
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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: 10/28/99 electroencephalography-severe cerebral distrubances;MRI intraparenchymatous lesions evoked dx of herpetic infect process;herpes;lyme negative;mycoplasm IG=12;10/30/99 electroenephalography-confirmed aggravation of cerebral lesions;
CDC 'Split Type': WAES99111051

Write-up: p/vax pt w/drowsiness & cephalagia;hosp & fever & tonic clonic convuls;no motor deficiency but paresthesia & meningism (nausea & neck stiffness);pt confused;to ICU exp cardiac & resp arrest;state IV coma;dx meningoencephalitis;pt died


Changed on 10/14/2018

VAERS ID: 131353 Before After
VAERS Form:1
Age:10.0
Sex:Male
Location:Foreign
Vaccinated:1999-10-21
Onset:1999-10-24
Submitted:1999-11-19
Entered:1999-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 2 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Cardiac arrest, Coma, Confusional state, Convulsion, Electroencephalogram abnormal, Encephalitis, Headache, Infection, Laboratory test abnormal, Meningitis, Nausea, Paraesthesia, Pyrexia, Somnolence, Nuchal rigidity, CSF test abnormal

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1999-11-04
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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: 10/28/99 electroencephalography-severe cerebral distrubances;MRI intraparenchymatous lesions evoked dx of herpetic infect process;herpes;lyme negative;mycoplasm IG=12;10/30/99 electroenephalography-confirmed aggravation of cerebral lesions;
CDC 'Split Type': WAES99111051

Write-up: p/vax pt w/drowsiness & cephalagia;hosp & fever & tonic clonic convuls;no motor deficiency but paresthesia & meningism (nausea & neck stiffness);pt confused;to ICU exp cardiac & resp arrest;state IV coma;dx meningoencephalitis;pt died

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=131353&WAYBACKHISTORY=ON


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