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This is VAERS ID 181884

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 181884
VAERS Form:
Age:9.0
Sex:Female
Location:New York
Vaccinated:2002-01-25
Onset:2002-01-28
Submitted:2002-02-25
Entered:2002-03-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECH ENG5292A2 / 0 LA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0736L / 0 RA / SC

Administered by: Private      Purchased by: Unknown
Symptoms: FEVER, DYSPNEA, TACHYCARDIA

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2002-02-08
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: Extensive antibiotics; prednisone
Current Illness: Advanced Cystic Fibrosis
Preexisting Conditions: Cystic Fibrosis; diabetes
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Shots were given on 1/25/02. On 1/28/02, the pt had a temperature of 104F, extreme shortness of breath (requiring 10 liters of oxygen) to help alleviate. Also, had a heart rate of 180 +.


Changed on 12/8/2009

VAERS ID: 181884 Before After
VAERS Form:
Age:9.0
Sex:Female
Location:New York
Vaccinated:2002-01-25
Onset:2002-01-28
Submitted:2002-02-25
Entered:2002-03-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECH SMITHKLINE BEECHAM ENG5292A2 5292A2 / 0 LA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0736L / 0 RA / SC

Administered by: Private      Purchased by: Unknown Other
Symptoms: Dyspnoea, Heart rate increased, Pyrexia, FEVER, DYSPNEA, TACHYCARDIA

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2002-02-08
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: Extensive antibiotics; prednisone
Current Illness: Advanced Cystic Fibrosis
Preexisting Conditions: Cystic Fibrosis; diabetes
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Shots were given on 1/25/02. On 1/28/02, the pt had a temperature of 104F, extreme shortness of breath (requiring 10 liters of oxygen) to help alleviate. Also, had a heart rate of 180 +.


Changed on 9/14/2017

VAERS ID: 181884 Before After
VAERS Form:(blank) 1
Age:9.0
Sex:Female
Location:New York
Vaccinated:2002-01-25
Onset:2002-01-28
Submitted:2002-02-25
Entered:2002-03-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 5292A2 / 0 1 LA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0736L / 0 1 RA / SC

Administered by: Private      Purchased by: Other
Symptoms: Dyspnoea, Heart rate increased, Pyrexia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2002-02-08
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: Extensive antibiotics; prednisone
Current Illness: Advanced Cystic Fibrosis
Preexisting Conditions: Cystic Fibrosis; diabetes
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Shots were given on 1/25/02. On 1/28/02, the pt had a temperature of 104F, extreme shortness of breath (requiring 10 liters of oxygen) to help alleviate. Also, had a heart rate of 180 +.


Changed on 2/14/2018

VAERS ID: 181884 Before After
VAERS Form:1
Age:9.0
Sex:Female
Location:New York
Vaccinated:2002-01-25
Onset:2002-01-28
Submitted:2002-02-25
Entered:2002-03-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 5292A2 / 1 LA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0736L / 1 RA / SC

Administered by: Private      Purchased by: Other
Symptoms: Dyspnoea, Heart rate increased, Pyrexia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2002-02-08
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: Extensive antibiotics; prednisone
Current Illness: Advanced Cystic Fibrosis
Preexisting Conditions: Cystic Fibrosis; diabetes
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Shots were given on 1/25/02. On 1/28/02, the pt had a temperature of 104F, extreme shortness of breath (requiring 10 liters of oxygen) to help alleviate. Also, had a heart rate of 180 +.


Changed on 6/14/2018

VAERS ID: 181884 Before After
VAERS Form:1
Age:9.0
Sex:Female
Location:New York
Vaccinated:2002-01-25
Onset:2002-01-28
Submitted:2002-02-25
Entered:2002-03-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 5292A2 / 1 LA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0736L / 1 RA / SC

Administered by: Private      Purchased by: Other
Symptoms: Dyspnoea, Heart rate increased, Pyrexia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2002-02-08
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: Extensive antibiotics; prednisone
Current Illness: Advanced Cystic Fibrosis
Preexisting Conditions: Cystic Fibrosis; diabetes
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Shots were given on 1/25/02. On 1/28/02, the pt had a temperature of 104F, extreme shortness of breath (requiring 10 liters of oxygen) to help alleviate. Also, had a heart rate of 180 +.


Changed on 8/14/2018

VAERS ID: 181884 Before After
VAERS Form:1
Age:9.0
Sex:Female
Location:New York
Vaccinated:2002-01-25
Onset:2002-01-28
Submitted:2002-02-25
Entered:2002-03-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 5292A2 / 1 LA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0736L / 1 RA / SC

Administered by: Private      Purchased by: Other
Symptoms: Dyspnoea, Heart rate increased, Pyrexia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2002-02-08
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: Extensive antibiotics; prednisone
Current Illness: Advanced Cystic Fibrosis
Preexisting Conditions: Cystic Fibrosis; diabetes
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Shots were given on 1/25/02. On 1/28/02, the pt had a temperature of 104F, extreme shortness of breath (requiring 10 liters of oxygen) to help alleviate. Also, had a heart rate of 180 +.


Changed on 9/14/2018

VAERS ID: 181884 Before After
VAERS Form:1
Age:9.0
Sex:Female
Location:New York
Vaccinated:2002-01-25
Onset:2002-01-28
Submitted:2002-02-25
Entered:2002-03-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 5292A2 / 1 LA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0736L / 1 RA / SC

Administered by: Private      Purchased by: Other
Symptoms: Dyspnoea, Heart rate increased, Pyrexia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2002-02-08
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: Extensive antibiotics; prednisone
Current Illness: Advanced Cystic Fibrosis
Preexisting Conditions: Cystic Fibrosis; diabetes
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Shots were given on 1/25/02. On 1/28/02, the pt had a temperature of 104F, extreme shortness of breath (requiring 10 liters of oxygen) to help alleviate. Also, had a heart rate of 180 +.


Changed on 10/14/2018

VAERS ID: 181884 Before After
VAERS Form:1
Age:9.0
Sex:Female
Location:New York
Vaccinated:2002-01-25
Onset:2002-01-28
Submitted:2002-02-25
Entered:2002-03-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 5292A2 / 1 LA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0736L / 1 RA / SC

Administered by: Private      Purchased by: Other
Symptoms: Dyspnoea, Heart rate increased, Pyrexia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2002-02-08
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: Extensive antibiotics; prednisone
Current Illness: Advanced Cystic Fibrosis
Preexisting Conditions: Cystic Fibrosis; diabetes
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Shots were given on 1/25/02. On 1/28/02, the pt had a temperature of 104F, extreme shortness of breath (requiring 10 liters of oxygen) to help alleviate. Also, had a heart rate of 180 +.

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=181884&WAYBACKHISTORY=ON


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