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This is VAERS ID 152670

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 152670
VAERS Form:
Age:1.1
Sex:Female
Location:Massachusetts
Vaccinated:2000-05-15
Onset:2000-05-25
Submitted:2000-05-30
Entered:2000-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIBTITER / LEDERLE(PRAXIS) 560903A / 3 LL / IM
MMR: MMR II / MSD 1275J / 0 RL / SC

Administered by: Private      Purchased by: Unknown
Symptoms: FEVER, APNEA, LIVER DAMAGE, EDEMA BRAIN, ATELECTASIS

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-05-28
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: PPD - Lot number 0090P, ID, RA
Current Illness: NONE
Preexisting Conditions: febrile seizures, pneumococcal bacteremia
Allergies:
Diagnostic Lab Data: CBC-5500
CDC 'Split Type':

Write-up: on 5/25/00, pt had fever, cold symptoms for 2 days, runny nose, red pharynx, a few papules on face, WBC 5,500. 5/27 via phone call, pt was pale, had macular rash on nose and face, fever was 100.8. Pt was taken to ER on 5/28. DOA, (probably several hours)."Autopsy states liver congestion, lung atelectasis, lung congestion, respiratory failure due to streptococcal (group B) pneumonia, ceberal edema,


Changed on 12/8/2009

VAERS ID: 152670 Before After
VAERS Form:
Age:1.1
Sex:Female
Location:Massachusetts
Vaccinated:2000-05-15
Onset:2000-05-25
Submitted:2000-05-30
Entered:2000-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIBTITER HIB (HIBTITER) / LEDERLE(PRAXIS) LEDERLE PRAXSIS 560903A / 3 LL / IM
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 1275J / 0 RL / SC

Administered by: Private      Purchased by: Unknown Public
Symptoms: Atelectasis, Liver disorder, Pallor, Pharyngitis, Pneumonia, Pulmonary congestion, Pyrexia, Rash macular, Respiratory failure, Rhinitis, Brain oedema, FEVER, APNEA, LIVER DAMAGE, EDEMA BRAIN, ATELECTASIS

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-05-28
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: PPD - Lot number 0090P, ID, RA
Current Illness: NONE
Preexisting Conditions: febrile seizures, pneumococcal bacteremia
Allergies:
Diagnostic Lab Data: CBC-5500
CDC 'Split Type':

Write-up: on 5/25/00, pt had fever, cold symptoms for 2 days, runny nose, red pharynx, a few papules on face, WBC 5,500. 5/27 via phone call, pt was pale, had macular rash on nose and face, fever was 100.8. Pt was taken to ER on 5/28. DOA, (probably several hours)."Autopsy hours). Autopsy states liver congestion, lung atelectasis, lung congestion, respiratory failure due to streptococcal (group B) pneumonia, ceberal edema,


Changed on 6/11/2011

VAERS ID: 152670 Before After
VAERS Form:
Age:1.1
Sex:Female
Location:Massachusetts
Vaccinated:2000-05-15
Onset:2000-05-25
Submitted:2000-05-30
Entered:2000-06-07 2000-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / LEDERLE PRAXSIS 560903A / 3 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1275J / 0 RL / SC

Administered by: Private      Purchased by: Public
Symptoms: Atelectasis, Liver disorder, Pallor, Pharyngitis, Pneumonia, Pulmonary congestion, Pyrexia, Rash macular, Respiratory failure, Rhinitis, Brain oedema

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-05-28
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: PPD - Lot number 0090P, ID, RA
Current Illness: NONE
Preexisting Conditions: febrile seizures, pneumococcal bacteremia
Allergies:
Diagnostic Lab Data: CBC-5500
CDC 'Split Type':

Write-up: on 5/25/00, pt had fever, cold symptoms for 2 days, runny nose, red pharynx, a few papules on face, WBC 5,500. 5/27 via phone call, pt was pale, had macular rash on nose and face, fever was 100.8. Pt was taken to ER on 5/28. DOA, (probably several hours). Autopsy states liver congestion, lung atelectasis, lung congestion, respiratory failure due to streptococcal (group B) pneumonia, ceberal edema,


Changed on 2/14/2017

VAERS ID: 152670 Before After
VAERS Form:
Age:1.1 1.08
Sex:Female
Location:Massachusetts
Vaccinated:2000-05-15
Onset:2000-05-25
Submitted:2000-05-30
Entered:2000-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / LEDERLE PRAXSIS 560903A / 3 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1275J / 0 RL / SC

Administered by: Private      Purchased by: Public
Symptoms: Atelectasis, Liver disorder, Pallor, Pharyngitis, Pneumonia, Pulmonary congestion, Pyrexia, Rash macular, Respiratory failure, Rhinitis, Brain oedema

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-05-28
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: PPD - Lot number 0090P, ID, RA
Current Illness: NONE
Preexisting Conditions: febrile seizures, pneumococcal bacteremia
Allergies:
Diagnostic Lab Data: CBC-5500
CDC 'Split Type':

Write-up: on 5/25/00, pt had fever, cold symptoms for 2 days, runny nose, red pharynx, a few papules on face, WBC 5,500. 5/27 via phone call, pt was pale, had macular rash on nose and face, fever was 100.8. Pt was taken to ER on 5/28. DOA, (probably several hours). Autopsy states liver congestion, lung atelectasis, lung congestion, respiratory failure due to streptococcal (group B) pneumonia, ceberal edema,


Changed on 5/14/2017

VAERS ID: 152670 Before After
VAERS Form:
Age:1.08
Sex:Female
Location:Massachusetts
Vaccinated:2000-05-15
Onset:2000-05-25
Submitted:2000-05-30
Entered:2000-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / LEDERLE PRAXSIS PFIZER/WYETH 560903A / 3 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1275J / 0 RL / SC

Administered by: Private      Purchased by: Public
Symptoms: Atelectasis, Liver disorder, Pallor, Pharyngitis, Pneumonia, Pulmonary congestion, Pyrexia, Rash macular, Respiratory failure, Rhinitis, Brain oedema

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-05-28
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: PPD - Lot number 0090P, ID, RA
Current Illness: NONE
Preexisting Conditions: febrile seizures, pneumococcal bacteremia
Allergies:
Diagnostic Lab Data: CBC-5500
CDC 'Split Type':

Write-up: on 5/25/00, pt had fever, cold symptoms for 2 days, runny nose, red pharynx, a few papules on face, WBC 5,500. 5/27 via phone call, pt was pale, had macular rash on nose and face, fever was 100.8. Pt was taken to ER on 5/28. DOA, (probably several hours). Autopsy states liver congestion, lung atelectasis, lung congestion, respiratory failure due to streptococcal (group B) pneumonia, ceberal edema,


Changed on 9/14/2017

VAERS ID: 152670 Before After
VAERS Form:(blank) 1
Age:1.08
Sex:Female
Location:Massachusetts
Vaccinated:2000-05-15
Onset:2000-05-25
Submitted:2000-05-30
Entered:2000-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH 560903A / 3 4 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1275J / 0 1 RL / SC

Administered by: Private      Purchased by: Public
Symptoms: Atelectasis, Liver disorder, Pallor, Pharyngitis, Pneumonia, Pulmonary congestion, Pyrexia, Rash macular, Respiratory failure, Rhinitis, Brain oedema

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-05-28
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: PPD - Lot number 0090P, ID, RA
Current Illness: NONE
Preexisting Conditions: febrile seizures, pneumococcal bacteremia
Allergies:
Diagnostic Lab Data: CBC-5500
CDC 'Split Type':

Write-up: on 5/25/00, pt had fever, cold symptoms for 2 days, runny nose, red pharynx, a few papules on face, WBC 5,500. 5/27 via phone call, pt was pale, had macular rash on nose and face, fever was 100.8. Pt was taken to ER on 5/28. DOA, (probably several hours). Autopsy states liver congestion, lung atelectasis, lung congestion, respiratory failure due to streptococcal (group B) pneumonia, ceberal edema,


Changed on 2/14/2018

VAERS ID: 152670 Before After
VAERS Form:1
Age:1.08
Sex:Female
Location:Massachusetts
Vaccinated:2000-05-15
Onset:2000-05-25
Submitted:2000-05-30
Entered:2000-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH 560903A / 4 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1275J / 1 RL / SC

Administered by: Private      Purchased by: Public
Symptoms: Atelectasis, Liver disorder, Pallor, Pharyngitis, Pneumonia, Pulmonary congestion, Pyrexia, Rash macular, Respiratory failure, Rhinitis, Brain oedema

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-05-28
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: PPD - Lot number 0090P, ID, RA
Current Illness: NONE
Preexisting Conditions: febrile seizures, pneumococcal bacteremia
Allergies:
Diagnostic Lab Data: CBC-5500
CDC 'Split Type':

Write-up: on 5/25/00, pt had fever, cold symptoms for 2 days, runny nose, red pharynx, a few papules on face, WBC 5,500. 5/27 via phone call, pt was pale, had macular rash on nose and face, fever was 100.8. Pt was taken to ER on 5/28. DOA, (probably several hours). Autopsy states liver congestion, lung atelectasis, lung congestion, respiratory failure due to streptococcal (group B) pneumonia, ceberal edema,


Changed on 6/14/2018

VAERS ID: 152670 Before After
VAERS Form:1
Age:1.08
Sex:Female
Location:Massachusetts
Vaccinated:2000-05-15
Onset:2000-05-25
Submitted:2000-05-30
Entered:2000-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH 560903A / 4 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1275J / 1 RL / SC

Administered by: Private      Purchased by: Public
Symptoms: Atelectasis, Liver disorder, Pallor, Pharyngitis, Pneumonia, Pulmonary congestion, Pyrexia, Rash macular, Respiratory failure, Rhinitis, Brain oedema

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-05-28
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: PPD - Lot number 0090P, ID, RA
Current Illness: NONE
Preexisting Conditions: febrile seizures, pneumococcal bacteremia
Allergies:
Diagnostic Lab Data: CBC-5500
CDC 'Split Type':

Write-up: on 5/25/00, pt had fever, cold symptoms for 2 days, runny nose, red pharynx, a few papules on face, WBC 5,500. 5/27 via phone call, pt was pale, had macular rash on nose and face, fever was 100.8. Pt was taken to ER on 5/28. DOA, (probably several hours). Autopsy states liver congestion, lung atelectasis, lung congestion, respiratory failure due to streptococcal (group B) pneumonia, ceberal edema,


Changed on 8/14/2018

VAERS ID: 152670 Before After
VAERS Form:1
Age:1.08
Sex:Female
Location:Massachusetts
Vaccinated:2000-05-15
Onset:2000-05-25
Submitted:2000-05-30
Entered:2000-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH 560903A / 4 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1275J / 1 RL / SC

Administered by: Private      Purchased by: Public
Symptoms: Atelectasis, Liver disorder, Pallor, Pharyngitis, Pneumonia, Pulmonary congestion, Pyrexia, Rash macular, Respiratory failure, Rhinitis, Brain oedema

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-05-28
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: PPD - Lot number 0090P, ID, RA
Current Illness: NONE
Preexisting Conditions: febrile seizures, pneumococcal bacteremia
Allergies:
Diagnostic Lab Data: CBC-5500
CDC 'Split Type':

Write-up: on 5/25/00, pt had fever, cold symptoms for 2 days, runny nose, red pharynx, a few papules on face, WBC 5,500. 5/27 via phone call, pt was pale, had macular rash on nose and face, fever was 100.8. Pt was taken to ER on 5/28. DOA, (probably several hours). Autopsy states liver congestion, lung atelectasis, lung congestion, respiratory failure due to streptococcal (group B) pneumonia, ceberal edema,


Changed on 9/14/2018

VAERS ID: 152670 Before After
VAERS Form:1
Age:1.08
Sex:Female
Location:Massachusetts
Vaccinated:2000-05-15
Onset:2000-05-25
Submitted:2000-05-30
Entered:2000-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH 560903A / 4 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1275J / 1 RL / SC

Administered by: Private      Purchased by: Public
Symptoms: Atelectasis, Liver disorder, Pallor, Pharyngitis, Pneumonia, Pulmonary congestion, Pyrexia, Rash macular, Respiratory failure, Rhinitis, Brain oedema

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-05-28
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: PPD - Lot number 0090P, ID, RA
Current Illness: NONE
Preexisting Conditions: febrile seizures, pneumococcal bacteremia
Allergies:
Diagnostic Lab Data: CBC-5500
CDC 'Split Type':

Write-up: on 5/25/00, pt had fever, cold symptoms for 2 days, runny nose, red pharynx, a few papules on face, WBC 5,500. 5/27 via phone call, pt was pale, had macular rash on nose and face, fever was 100.8. Pt was taken to ER on 5/28. DOA, (probably several hours). Autopsy states liver congestion, lung atelectasis, lung congestion, respiratory failure due to streptococcal (group B) pneumonia, ceberal edema,


Changed on 10/14/2018

VAERS ID: 152670 Before After
VAERS Form:1
Age:1.08
Sex:Female
Location:Massachusetts
Vaccinated:2000-05-15
Onset:2000-05-25
Submitted:2000-05-30
Entered:2000-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH 560903A / 4 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1275J / 1 RL / SC

Administered by: Private      Purchased by: Public
Symptoms: Atelectasis, Liver disorder, Pallor, Pharyngitis, Pneumonia, Pulmonary congestion, Pyrexia, Rash macular, Respiratory failure, Rhinitis, Brain oedema

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-05-28
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: PPD - Lot number 0090P, ID, RA
Current Illness: NONE
Preexisting Conditions: febrile seizures, pneumococcal bacteremia
Allergies:
Diagnostic Lab Data: CBC-5500
CDC 'Split Type':

Write-up: on 5/25/00, pt had fever, cold symptoms for 2 days, runny nose, red pharynx, a few papules on face, WBC 5,500. 5/27 via phone call, pt was pale, had macular rash on nose and face, fever was 100.8. Pt was taken to ER on 5/28. DOA, (probably several hours). Autopsy states liver congestion, lung atelectasis, lung congestion, respiratory failure due to streptococcal (group B) pneumonia, ceberal edema,

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