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This is VAERS ID 184466

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 184466
VAERS Form:
Age:1.0
Sex:Male
Location:Louisiana
Vaccinated:2002-03-05
Onset:2002-03-18
Submitted:2002-05-07
Entered:2002-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (ACTHIB) / AVENTIS PASTEUR, UA610AA / 3 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0160L / 0 LL / SC
PNC: PNEUMO, 7-VALENT (PREVNAR) / LEDERLE LABORATO 484209 / 1 RL / IM

Administered by: Public      Purchased by: Unknown
Symptoms: ALLERG REACT, EDEMA BRAIN, HEM CEREBR, INFECT BACT

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2002-03-18
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: Pink throat and slightly enlarged tonsils and stuffy nose per F/U 6/10/02
Preexisting Conditions: Mom reported vomiting and diarrhea that stopped 4 days prior to death; went to ER per F/U 6/10/02, also has history of allergies
Allergies:
Diagnostic Lab Data: Autopsy performed-cause of death; nodular pneumonitis with allergic component
CDC 'Split Type':

Write-up: The pt died suddenly at the babysitter''s; dx on death certificate is nodular pneumonitis with allergic component. Mother is concerned that child''s allergic reaction was possibly related to vaccine. Received HIB, MMR, PCV-7 on 3/5/02. Per F/U 6/10/02 also"had cerebral edema and congestion, scattered colonies of bacterial-type elements within these nodular areas and intra-alveolar hemorrhage.


Changed on 12/8/2009

VAERS ID: 184466 Before After
VAERS Form:
Age:1.0
Sex:Male
Location:Louisiana
Vaccinated:2002-03-05
Onset:2002-03-18
Submitted:2002-05-07
Entered:2002-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (ACTHIB) / AVENTIS PASTEUR, AVENTIS PASTEUR UA610AA / 3 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0160L / 0 LL / SC
PNC: PNEUMO, 7-VALENT (PREVNAR) PNEUMO (PREVNAR) / LEDERLE LABORATO LEDERLE LABORATORIES 484209 / 1 RL / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Cerebral haemorrhage, Hypersensitivity, Brain oedema, Bacterial infection, ALLERG REACT, EDEMA BRAIN, HEM CEREBR, INFECT BACT

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2002-03-18
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: Pink throat and slightly enlarged tonsils and stuffy nose per F/U 6/10/02
Preexisting Conditions: Mom reported vomiting and diarrhea that stopped 4 days prior to death; went to ER per F/U 6/10/02, also has history of allergies
Allergies:
Diagnostic Lab Data: Autopsy performed-cause of death; nodular pneumonitis with allergic component
CDC 'Split Type': (blank) LA020501

Write-up: The pt died suddenly at the babysitter''s; dx on death certificate is nodular pneumonitis with allergic component. Mother is concerned that child''s allergic reaction was possibly related to vaccine. Received HIB, MMR, PCV-7 on 3/5/02. Per F/U 6/10/02 also"had also had cerebral edema and congestion, scattered colonies of bacterial-type elements within these nodular areas and intra-alveolar hemorrhage.


Changed on 3/2/2010

VAERS ID: 184466 Before After
VAERS Form:
Age:1.0
Sex:Male
Location:Louisiana
Vaccinated:2002-03-05
Onset:2002-03-18
Submitted:2002-05-07
Entered:2002-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (ACTHIB) / AVENTIS PASTEUR UA610AA / 3 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0160L / 0 LL / SC
PNC: PNEUMO (PREVNAR) PNEUMO (PREVNAR7) / LEDERLE LABORATORIES 484209 / 1 RL / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Cerebral haemorrhage, Hypersensitivity, Brain oedema, Bacterial infection

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2002-03-18
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: Pink throat and slightly enlarged tonsils and stuffy nose per F/U 6/10/02
Preexisting Conditions: Mom reported vomiting and diarrhea that stopped 4 days prior to death; went to ER per F/U 6/10/02, also has history of allergies
Allergies:
Diagnostic Lab Data: Autopsy performed-cause of death; nodular pneumonitis with allergic component
CDC 'Split Type': LA020501

Write-up: The pt died suddenly at the babysitter''s; dx on death certificate is nodular pneumonitis with allergic component. Mother is concerned that child''s allergic reaction was possibly related to vaccine. Received HIB, MMR, PCV-7 on 3/5/02. Per F/U 6/10/02 also had cerebral edema and congestion, scattered colonies of bacterial-type elements within these nodular areas and intra-alveolar hemorrhage.


Changed on 4/7/2010

VAERS ID: 184466 Before After
VAERS Form:
Age:1.0
Sex:Male
Location:Louisiana
Vaccinated:2002-03-05
Onset:2002-03-18
Submitted:2002-05-07
Entered:2002-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (ACTHIB) / AVENTIS PASTEUR UA610AA / 3 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0160L / 0 LL / SC
PNC: PNEUMO (PREVNAR7) PNEUMO (PREVNAR) / LEDERLE LABORATORIES 484209 / 1 RL / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Cerebral haemorrhage, Hypersensitivity, Brain oedema, Bacterial infection

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2002-03-18
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: Pink throat and slightly enlarged tonsils and stuffy nose per F/U 6/10/02
Preexisting Conditions: Mom reported vomiting and diarrhea that stopped 4 days prior to death; went to ER per F/U 6/10/02, also has history of allergies
Allergies:
Diagnostic Lab Data: Autopsy performed-cause of death; nodular pneumonitis with allergic component
CDC 'Split Type': LA020501

Write-up: The pt died suddenly at the babysitter''s; dx on death certificate is nodular pneumonitis with allergic component. Mother is concerned that child''s allergic reaction was possibly related to vaccine. Received HIB, MMR, PCV-7 on 3/5/02. Per F/U 6/10/02 also had cerebral edema and congestion, scattered colonies of bacterial-type elements within these nodular areas and intra-alveolar hemorrhage.


Changed on 2/14/2017

VAERS ID: 184466 Before After
VAERS Form:
Age:1.0
Sex:Male
Location:Louisiana
Vaccinated:2002-03-05
Onset:2002-03-18
Submitted:2002-05-07
Entered:2002-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (ACTHIB) / AVENTIS PASTEUR SANOFI PASTEUR UA610AA / 3 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0160L / 0 LL / SC
PNC: PNEUMO (PREVNAR) / LEDERLE LABORATORIES PFIZER/WYETH 484209 / 1 RL / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Cerebral haemorrhage, Hypersensitivity, Brain oedema, Bacterial infection

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2002-03-18
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: Pink throat and slightly enlarged tonsils and stuffy nose per F/U 6/10/02
Preexisting Conditions: Mom reported vomiting and diarrhea that stopped 4 days prior to death; went to ER per F/U 6/10/02, also has history of allergies
Allergies:
Diagnostic Lab Data: Autopsy performed-cause of death; nodular pneumonitis with allergic component
CDC 'Split Type': LA020501

Write-up: The pt died suddenly at the babysitter''s; dx on death certificate is nodular pneumonitis with allergic component. Mother is concerned that child''s allergic reaction was possibly related to vaccine. Received HIB, MMR, PCV-7 on 3/5/02. Per F/U 6/10/02 also had cerebral edema and congestion, scattered colonies of bacterial-type elements within these nodular areas and intra-alveolar hemorrhage.


Changed on 9/14/2017

VAERS ID: 184466 Before After
VAERS Form:(blank) 1
Age:1.0
Sex:Male
Location:Louisiana
Vaccinated:2002-03-05
Onset:2002-03-18
Submitted:2002-05-07
Entered:2002-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UA610AA / 3 4 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0160L / 0 1 LL / SC
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH 484209 / 1 2 RL / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Cerebral haemorrhage, Hypersensitivity, Brain oedema, Bacterial infection

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2002-03-18
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: Pink throat and slightly enlarged tonsils and stuffy nose per F/U 6/10/02
Preexisting Conditions: Mom reported vomiting and diarrhea that stopped 4 days prior to death; went to ER per F/U 6/10/02, also has history of allergies
Allergies:
Diagnostic Lab Data: Autopsy performed-cause of death; nodular pneumonitis with allergic component
CDC 'Split Type': LA020501

Write-up: The pt died suddenly at the babysitter''s; dx on death certificate is nodular pneumonitis with allergic component. Mother is concerned that child''s allergic reaction was possibly related to vaccine. Received HIB, MMR, PCV-7 on 3/5/02. Per F/U 6/10/02 also had cerebral edema and congestion, scattered colonies of bacterial-type elements within these nodular areas and intra-alveolar hemorrhage.


Changed on 2/14/2018

VAERS ID: 184466 Before After
VAERS Form:1
Age:1.0
Sex:Male
Location:Louisiana
Vaccinated:2002-03-05
Onset:2002-03-18
Submitted:2002-05-07
Entered:2002-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UA610AA / 4 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0160L / 1 LL / SC
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH 484209 / 2 RL / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Cerebral haemorrhage, Hypersensitivity, Brain oedema, Bacterial infection

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2002-03-18
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: Pink throat and slightly enlarged tonsils and stuffy nose per F/U 6/10/02
Preexisting Conditions: Mom reported vomiting and diarrhea that stopped 4 days prior to death; went to ER per F/U 6/10/02, also has history of allergies
Allergies:
Diagnostic Lab Data: Autopsy performed-cause of death; nodular pneumonitis with allergic component
CDC 'Split Type': LA020501

Write-up: The pt died suddenly at the babysitter''s; dx on death certificate is nodular pneumonitis with allergic component. Mother is concerned that child''s allergic reaction was possibly related to vaccine. Received HIB, MMR, PCV-7 on 3/5/02. Per F/U 6/10/02 also had cerebral edema and congestion, scattered colonies of bacterial-type elements within these nodular areas and intra-alveolar hemorrhage.


Changed on 6/14/2018

VAERS ID: 184466 Before After
VAERS Form:1
Age:1.0
Sex:Male
Location:Louisiana
Vaccinated:2002-03-05
Onset:2002-03-18
Submitted:2002-05-07
Entered:2002-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UA610AA / 4 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0160L / 1 LL / SC
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH 484209 / 2 RL / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Cerebral haemorrhage, Hypersensitivity, Brain oedema, Bacterial infection

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2002-03-18
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: Pink throat and slightly enlarged tonsils and stuffy nose per F/U 6/10/02
Preexisting Conditions: Mom reported vomiting and diarrhea that stopped 4 days prior to death; went to ER per F/U 6/10/02, also has history of allergies
Allergies:
Diagnostic Lab Data: Autopsy performed-cause of death; nodular pneumonitis with allergic component
CDC 'Split Type': LA020501

Write-up: The pt died suddenly at the babysitter''s; dx on death certificate is nodular pneumonitis with allergic component. Mother is concerned that child''s allergic reaction was possibly related to vaccine. Received HIB, MMR, PCV-7 on 3/5/02. Per F/U 6/10/02 also had cerebral edema and congestion, scattered colonies of bacterial-type elements within these nodular areas and intra-alveolar hemorrhage.


Changed on 8/14/2018

VAERS ID: 184466 Before After
VAERS Form:1
Age:1.0
Sex:Male
Location:Louisiana
Vaccinated:2002-03-05
Onset:2002-03-18
Submitted:2002-05-07
Entered:2002-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UA610AA / 4 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0160L / 1 LL / SC
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH 484209 / 2 RL / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Cerebral haemorrhage, Hypersensitivity, Brain oedema, Bacterial infection

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2002-03-18
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: Pink throat and slightly enlarged tonsils and stuffy nose per F/U 6/10/02
Preexisting Conditions: Mom reported vomiting and diarrhea that stopped 4 days prior to death; went to ER per F/U 6/10/02, also has history of allergies
Allergies:
Diagnostic Lab Data: Autopsy performed-cause of death; nodular pneumonitis with allergic component
CDC 'Split Type': LA020501

Write-up: The pt died suddenly at the babysitter''s; dx on death certificate is nodular pneumonitis with allergic component. Mother is concerned that child''s allergic reaction was possibly related to vaccine. Received HIB, MMR, PCV-7 on 3/5/02. Per F/U 6/10/02 also had cerebral edema and congestion, scattered colonies of bacterial-type elements within these nodular areas and intra-alveolar hemorrhage.


Changed on 9/14/2018

VAERS ID: 184466 Before After
VAERS Form:1
Age:1.0
Sex:Male
Location:Louisiana
Vaccinated:2002-03-05
Onset:2002-03-18
Submitted:2002-05-07
Entered:2002-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UA610AA / 4 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0160L / 1 LL / SC
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH 484209 / 2 RL / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Cerebral haemorrhage, Hypersensitivity, Brain oedema, Bacterial infection

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2002-03-18
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: Pink throat and slightly enlarged tonsils and stuffy nose per F/U 6/10/02
Preexisting Conditions: Mom reported vomiting and diarrhea that stopped 4 days prior to death; went to ER per F/U 6/10/02, also has history of allergies
Allergies:
Diagnostic Lab Data: Autopsy performed-cause of death; nodular pneumonitis with allergic component
CDC 'Split Type': LA020501

Write-up: The pt died suddenly at the babysitter''s; dx on death certificate is nodular pneumonitis with allergic component. Mother is concerned that child''s allergic reaction was possibly related to vaccine. Received HIB, MMR, PCV-7 on 3/5/02. Per F/U 6/10/02 also had cerebral edema and congestion, scattered colonies of bacterial-type elements within these nodular areas and intra-alveolar hemorrhage.


Changed on 10/14/2018

VAERS ID: 184466 Before After
VAERS Form:1
Age:1.0
Sex:Male
Location:Louisiana
Vaccinated:2002-03-05
Onset:2002-03-18
Submitted:2002-05-07
Entered:2002-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UA610AA / 4 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0160L / 1 LL / SC
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH 484209 / 2 RL / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Cerebral haemorrhage, Hypersensitivity, Brain oedema, Bacterial infection

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2002-03-18
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: Pink throat and slightly enlarged tonsils and stuffy nose per F/U 6/10/02
Preexisting Conditions: Mom reported vomiting and diarrhea that stopped 4 days prior to death; went to ER per F/U 6/10/02, also has history of allergies
Allergies:
Diagnostic Lab Data: Autopsy performed-cause of death; nodular pneumonitis with allergic component
CDC 'Split Type': LA020501

Write-up: The pt died suddenly at the babysitter''s; dx on death certificate is nodular pneumonitis with allergic component. Mother is concerned that child''s allergic reaction was possibly related to vaccine. Received HIB, MMR, PCV-7 on 3/5/02. Per F/U 6/10/02 also had cerebral edema and congestion, scattered colonies of bacterial-type elements within these nodular areas and intra-alveolar hemorrhage.

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