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This is VAERS ID 134580

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 134580
VAERS Form:
Age:1.0
Sex:Female
Location:Foreign
Vaccinated:1999-12-08
Onset:1999-12-17
Submitted:2000-03-01
Entered:2000-03-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / - - / IM
MEN: MENINGOCOCCAL (MENOMUNE) / CONNAUGHT LABORATORIES - / - - / SC
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / - - / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Convulsion, Hernia, Pneumonia, CSF test abnormal

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1999-12-18
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:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Cerebrospinal fluid-protein rasied (1.2g/l)
CDC 'Split Type': 20000052892

Write-up: 9 days post vax, pt exp convulsions. Overnight neurological status worsened, pt died early 11/18. Cause of death: convulsion NOS. Post-mortem: bronchopneumonia, tonsillar herniation. Final brain post-mortem awaited. No further info avail.


Changed on 5/14/2017

VAERS ID: 134580 Before After
VAERS Form:
Age:1.0
Sex:Female
Location:Foreign
Vaccinated:1999-12-08
Onset:1999-12-17
Submitted:2000-03-01
Entered:2000-03-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / - - / IM
MEN: MENINGOCOCCAL (MENOMUNE) / CONNAUGHT LABORATORIES - / - - / SC
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / - - / SC
MNC: MENINGOCOCCAL (MENINGITEC) / PFIZER/WYETH - / - - / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Convulsion, Hernia, Pneumonia, CSF test abnormal

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1999-12-18
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:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Cerebrospinal fluid-protein rasied (1.2g/l)
CDC 'Split Type': 20000052892

Write-up: 9 days post vax, pt exp convulsions. Overnight neurological status worsened, pt died early 11/18. Cause of death: convulsion NOS. Post-mortem: bronchopneumonia, tonsillar herniation. Final brain post-mortem awaited. No further info avail.


Changed on 9/14/2017

VAERS ID: 134580 Before After
VAERS Form:(blank) 1
Age:1.0
Sex:Female
Location:Foreign
Vaccinated:1999-12-08
Onset:1999-12-17
Submitted:2000-03-01
Entered:2000-03-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / - UNK - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / - UNK - / SC
MNC: MENINGOCOCCAL (MENINGITEC) / PFIZER/WYETH - / - UNK - / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Convulsion, Hernia, Pneumonia, CSF test abnormal

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1999-12-18
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:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Cerebrospinal fluid-protein rasied (1.2g/l)
CDC 'Split Type': 20000052892

Write-up: 9 days post vax, pt exp convulsions. Overnight neurological status worsened, pt died early 11/18. Cause of death: convulsion NOS. Post-mortem: bronchopneumonia, tonsillar herniation. Final brain post-mortem awaited. No further info avail.


Changed on 2/14/2018

VAERS ID: 134580 Before After
VAERS Form:1
Age:1.0
Sex:Female
Location:Foreign
Vaccinated:1999-12-08
Onset:1999-12-17
Submitted:2000-03-01
Entered:2000-03-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / UNK - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / SC
MNC: MENINGOCOCCAL (MENINGITEC) / PFIZER/WYETH - / UNK - / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Convulsion, Hernia, Pneumonia, CSF test abnormal

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1999-12-18
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:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Cerebrospinal fluid-protein rasied (1.2g/l)
CDC 'Split Type': 20000052892

Write-up: 9 days post vax, pt exp convulsions. Overnight neurological status worsened, pt died early 11/18. Cause of death: convulsion NOS. Post-mortem: bronchopneumonia, tonsillar herniation. Final brain post-mortem awaited. No further info avail.


Changed on 6/14/2018

VAERS ID: 134580 Before After
VAERS Form:1
Age:1.0
Sex:Female
Location:Foreign
Vaccinated:1999-12-08
Onset:1999-12-17
Submitted:2000-03-01
Entered:2000-03-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / UNK - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / SC
MNC: MENINGOCOCCAL (MENINGITEC) / PFIZER/WYETH - / UNK - / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Convulsion, Hernia, Pneumonia, CSF test abnormal

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1999-12-18
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:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Cerebrospinal fluid-protein rasied (1.2g/l)
CDC 'Split Type': 20000052892

Write-up: 9 days post vax, pt exp convulsions. Overnight neurological status worsened, pt died early 11/18. Cause of death: convulsion NOS. Post-mortem: bronchopneumonia, tonsillar herniation. Final brain post-mortem awaited. No further info avail.


Changed on 8/14/2018

VAERS ID: 134580 Before After
VAERS Form:1
Age:1.0
Sex:Female
Location:Foreign
Vaccinated:1999-12-08
Onset:1999-12-17
Submitted:2000-03-01
Entered:2000-03-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / UNK - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / SC
MNC: MENINGOCOCCAL (MENINGITEC) / PFIZER/WYETH - / UNK - / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Convulsion, Hernia, Pneumonia, CSF test abnormal

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1999-12-18
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:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Cerebrospinal fluid-protein rasied (1.2g/l)
CDC 'Split Type': 20000052892

Write-up: 9 days post vax, pt exp convulsions. Overnight neurological status worsened, pt died early 11/18. Cause of death: convulsion NOS. Post-mortem: bronchopneumonia, tonsillar herniation. Final brain post-mortem awaited. No further info avail.


Changed on 9/14/2018

VAERS ID: 134580 Before After
VAERS Form:1
Age:1.0
Sex:Female
Location:Foreign
Vaccinated:1999-12-08
Onset:1999-12-17
Submitted:2000-03-01
Entered:2000-03-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / UNK - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / SC
MNC: MENINGOCOCCAL (MENINGITEC) / PFIZER/WYETH - / UNK - / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Convulsion, Hernia, Pneumonia, CSF test abnormal

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1999-12-18
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:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Cerebrospinal fluid-protein rasied (1.2g/l)
CDC 'Split Type': 20000052892

Write-up: 9 days post vax, pt exp convulsions. Overnight neurological status worsened, pt died early 11/18. Cause of death: convulsion NOS. Post-mortem: bronchopneumonia, tonsillar herniation. Final brain post-mortem awaited. No further info avail.


Changed on 10/14/2018

VAERS ID: 134580 Before After
VAERS Form:1
Age:1.0
Sex:Female
Location:Foreign
Vaccinated:1999-12-08
Onset:1999-12-17
Submitted:2000-03-01
Entered:2000-03-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / UNK - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / SC
MNC: MENINGOCOCCAL (MENINGITEC) / PFIZER/WYETH - / UNK - / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Convulsion, Hernia, Pneumonia, CSF test abnormal

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1999-12-18
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:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Cerebrospinal fluid-protein rasied (1.2g/l)
CDC 'Split Type': 20000052892

Write-up: 9 days post vax, pt exp convulsions. Overnight neurological status worsened, pt died early 11/18. Cause of death: convulsion NOS. Post-mortem: bronchopneumonia, tonsillar herniation. Final brain post-mortem awaited. No further info avail.

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