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This is VAERS ID 174865

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 174865
VAERS Form:
Age:5.0
Sex:Female
Location:Texas
Vaccinated:2001-08-08
Onset:2001-08-12
Submitted:2001-08-22
Entered:2001-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MSD 0739L / 1 - / SC

Administered by: Private      Purchased by: Unknown
Symptoms: FEVER, HEADACHE, EDEMA BRAIN, HERNIA, INFECT VIRAL

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:2001-08-18
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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy results state histologic findings are most consistent with a viral etiology, however, antemortem serologic tests and postmorterm cultures fail to elucidate the etiology. Although ADEM was considered, stains failed to demonstrate a d
CDC 'Split Type':

Write-up: On 8/12/01, pt had a headache; on 8/14/01 pt had a headache and a fever; on 8/15/01, the pt was lethargic; on 08/17/01, pt had herniation and on 8/18/01; life support removed. Death certificate states cause of death to be cerebral edema due to viral illne"ss.


Changed on 12/8/2009

VAERS ID: 174865 Before After
VAERS Form:
Age:5.0
Sex:Female
Location:Texas
Vaccinated:2001-08-08
Onset:2001-08-12
Submitted:2001-08-22
Entered:2001-09-05 2001-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 0739L / 1 - / SC

Administered by: Private      Purchased by: Unknown Other
Symptoms: Headache, Hernia, Lethargy, Pyrexia, Viral infection, Brain oedema, FEVER, HEADACHE, EDEMA BRAIN, HERNIA, INFECT VIRAL

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:2001-08-18
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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy results state histologic findings are most consistent with a viral etiology, however, antemortem serologic tests and postmorterm cultures fail to elucidate the etiology. Although ADEM was considered, stains failed to demonstrate a d
CDC 'Split Type':

Write-up: On 8/12/01, pt had a headache; on 8/14/01 pt had a headache and a fever; on 8/15/01, the pt was lethargic; on 08/17/01, pt had herniation and on 8/18/01; life support removed. Death certificate states cause of death to be cerebral edema due to viral illne"ss. illness.


Changed on 2/14/2017

VAERS ID: 174865 Before After
VAERS Form:
Age:5.0
Sex:Female
Location:Texas
Vaccinated:2001-08-08
Onset:2001-08-12
Submitted:2001-08-22
Entered:2001-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0739L / 1 - / SC

Administered by: Private      Purchased by: Other
Symptoms: Headache, Hernia, Lethargy, Pyrexia, Viral infection, Brain oedema

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:2001-08-18
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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy results state histologic findings are most consistent with a viral etiology, however, antemortem serologic tests and postmorterm cultures fail to elucidate the etiology. Although ADEM was considered, stains failed to demonstrate a d demyelinating process as is classically demonstrated in this lesion.
CDC 'Split Type':

Write-up: On 8/12/01, pt had a headache; on 8/14/01 pt had a headache and a fever; on 8/15/01, the pt was lethargic; on 08/17/01, pt had herniation and on 8/18/01; life support removed. Death certificate states cause of death to be cerebral edema due to viral illness.


Changed on 9/14/2017

VAERS ID: 174865 Before After
VAERS Form:(blank) 1
Age:5.0
Sex:Female
Location:Texas
Vaccinated:2001-08-08
Onset:2001-08-12
Submitted:2001-08-22
Entered:2001-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0739L / 1 2 - / SC

Administered by: Private      Purchased by: Other
Symptoms: Headache, Hernia, Lethargy, Pyrexia, Viral infection, Brain oedema

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:2001-08-18
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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy results state histologic findings are most consistent with a viral etiology, however, antemortem serologic tests and postmorterm cultures fail to elucidate the etiology. Although ADEM was considered, stains failed to demonstrate a demyelinating process as is classically demonstrated in this lesion.
CDC 'Split Type':

Write-up: On 8/12/01, pt had a headache; on 8/14/01 pt had a headache and a fever; on 8/15/01, the pt was lethargic; on 08/17/01, pt had herniation and on 8/18/01; life support removed. Death certificate states cause of death to be cerebral edema due to viral illness.


Changed on 2/14/2018

VAERS ID: 174865 Before After
VAERS Form:1
Age:5.0
Sex:Female
Location:Texas
Vaccinated:2001-08-08
Onset:2001-08-12
Submitted:2001-08-22
Entered:2001-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0739L / 2 - / SC

Administered by: Private      Purchased by: Other
Symptoms: Headache, Hernia, Lethargy, Pyrexia, Viral infection, Brain oedema

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:2001-08-18
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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy results state histologic findings are most consistent with a viral etiology, however, antemortem serologic tests and postmorterm cultures fail to elucidate the etiology. Although ADEM was considered, stains failed to demonstrate a demyelinating process as is classically demonstrated in this lesion.
CDC 'Split Type':

Write-up: On 8/12/01, pt had a headache; on 8/14/01 pt had a headache and a fever; on 8/15/01, the pt was lethargic; on 08/17/01, pt had herniation and on 8/18/01; life support removed. Death certificate states cause of death to be cerebral edema due to viral illness.


Changed on 6/14/2018

VAERS ID: 174865 Before After
VAERS Form:1
Age:5.0
Sex:Female
Location:Texas
Vaccinated:2001-08-08
Onset:2001-08-12
Submitted:2001-08-22
Entered:2001-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0739L / 2 - / SC

Administered by: Private      Purchased by: Other
Symptoms: Headache, Hernia, Lethargy, Pyrexia, Viral infection, Brain oedema

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:2001-08-18
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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy results state histologic findings are most consistent with a viral etiology, however, antemortem serologic tests and postmorterm cultures fail to elucidate the etiology. Although ADEM was considered, stains failed to demonstrate a demyelinating process as is classically demonstrated in this lesion.
CDC 'Split Type':

Write-up: On 8/12/01, pt had a headache; on 8/14/01 pt had a headache and a fever; on 8/15/01, the pt was lethargic; on 08/17/01, pt had herniation and on 8/18/01; life support removed. Death certificate states cause of death to be cerebral edema due to viral illness.


Changed on 8/14/2018

VAERS ID: 174865 Before After
VAERS Form:1
Age:5.0
Sex:Female
Location:Texas
Vaccinated:2001-08-08
Onset:2001-08-12
Submitted:2001-08-22
Entered:2001-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0739L / 2 - / SC

Administered by: Private      Purchased by: Other
Symptoms: Headache, Hernia, Lethargy, Pyrexia, Viral infection, Brain oedema

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:2001-08-18
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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy results state histologic findings are most consistent with a viral etiology, however, antemortem serologic tests and postmorterm cultures fail to elucidate the etiology. Although ADEM was considered, stains failed to demonstrate a demyelinating process as is classically demonstrated in this lesion.
CDC 'Split Type':

Write-up: On 8/12/01, pt had a headache; on 8/14/01 pt had a headache and a fever; on 8/15/01, the pt was lethargic; on 08/17/01, pt had herniation and on 8/18/01; life support removed. Death certificate states cause of death to be cerebral edema due to viral illness.


Changed on 9/14/2018

VAERS ID: 174865 Before After
VAERS Form:1
Age:5.0
Sex:Female
Location:Texas
Vaccinated:2001-08-08
Onset:2001-08-12
Submitted:2001-08-22
Entered:2001-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0739L / 2 - / SC

Administered by: Private      Purchased by: Other
Symptoms: Headache, Hernia, Lethargy, Pyrexia, Viral infection, Brain oedema

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:2001-08-18
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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy results state histologic findings are most consistent with a viral etiology, however, antemortem serologic tests and postmorterm cultures fail to elucidate the etiology. Although ADEM was considered, stains failed to demonstrate a demyelinating process as is classically demonstrated in this lesion.
CDC 'Split Type':

Write-up: On 8/12/01, pt had a headache; on 8/14/01 pt had a headache and a fever; on 8/15/01, the pt was lethargic; on 08/17/01, pt had herniation and on 8/18/01; life support removed. Death certificate states cause of death to be cerebral edema due to viral illness.


Changed on 10/14/2018

VAERS ID: 174865 Before After
VAERS Form:1
Age:5.0
Sex:Female
Location:Texas
Vaccinated:2001-08-08
Onset:2001-08-12
Submitted:2001-08-22
Entered:2001-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0739L / 2 - / SC

Administered by: Private      Purchased by: Other
Symptoms: Headache, Hernia, Lethargy, Pyrexia, Viral infection, Brain oedema

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:2001-08-18
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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy results state histologic findings are most consistent with a viral etiology, however, antemortem serologic tests and postmorterm cultures fail to elucidate the etiology. Although ADEM was considered, stains failed to demonstrate a demyelinating process as is classically demonstrated in this lesion.
CDC 'Split Type':

Write-up: On 8/12/01, pt had a headache; on 8/14/01 pt had a headache and a fever; on 8/15/01, the pt was lethargic; on 08/17/01, pt had herniation and on 8/18/01; life support removed. Death certificate states cause of death to be cerebral edema due to viral illness.

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