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This is VAERS ID 187045

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 187045
VAERS Form:
Age:
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2002-07-05
Entered:2002-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / - - / -
TTOX: TETANUS TOXOID (UNKNOWN MFR) / UNKNOWN MFR - / - - / -

Administered by: Other      Purchased by: Unknown
Symptoms: ENCEPHALITIS, COMA, DEATH

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Hospitalization
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Information has been received from a physician concerning a pt who was vaccinated with a dose of MMR II. The reporter ""heard"" that the pt ""may have had a serious adverse event"" and requested information regarding MMR II, encephalitis and coma. Unspeci"fied medical attention was sought; however, the reporting physician noted that the pt was ""not his pt."" The reporter considered the adverse event to be an other important medical event. Additional info has been requested. Follow-up info was received on


Changed on 12/8/2009

VAERS ID: 187045 Before After
VAERS Form:
Age:
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2002-07-05
Entered:2002-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / - - / -
TTOX: TETANUS TOXOID (UNKNOWN MFR) TETANUS TOXOID (NO BRAND NAME) / UNKNOWN MFR UNKNOWN MANUFACTURER - / - - / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Coma, Encephalitis, ENCEPHALITIS, COMA, DEATH

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Hospitalization
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) WAES0206USA01625

Write-up: Information has been received from a physician concerning a pt who was vaccinated with a dose of MMR II. The reporter ""heard"" "heard" that the pt ""may "may have had a serious adverse event"" event" and requested information regarding MMR II, encephalitis and coma. Unspeci"fied Unspecified medical attention was sought; however, the reporting physician noted that the pt was ""not "not his pt."" pt." The reporter considered the adverse event to be an other important medical event. Additional info has been requested. Follow-up info was received on 06/27/02. The physician revealed that he is acting as a consutant on a legal case concerning this pt. He reported that she went on to develop encephalitis and later died. The reporter considered the encehalitis to be an other important medical event. Additional info has been requested.


Changed on 9/14/2017

VAERS ID: 187045 Before After
VAERS Form:(blank) 1
Age:
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2002-07-05
Entered:2002-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / - UNK - / -
TTOX: TETANUS TOXOID (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Coma, Encephalitis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Hospitalization
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0206USA01625

Write-up: Information has been received from a physician concerning a pt who was vaccinated with a dose of MMR II. The reporter "heard" that the pt "may have had a serious adverse event" and requested information regarding MMR II, encephalitis and coma. Unspecified medical attention was sought; however, the reporting physician noted that the pt was "not his pt." The reporter considered the adverse event to be an other important medical event. Additional info has been requested. Follow-up info was received on 06/27/02. The physician revealed that he is acting as a consutant on a legal case concerning this pt. He reported that she went on to develop encephalitis and later died. The reporter considered the encehalitis to be an other important medical event. Additional info has been requested.


Changed on 2/14/2018

VAERS ID: 187045 Before After
VAERS Form:1
Age:
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2002-07-05
Entered:2002-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -
TTOX: TETANUS TOXOID (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Coma, Encephalitis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Hospitalization
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0206USA01625

Write-up: Information has been received from a physician concerning a pt who was vaccinated with a dose of MMR II. The reporter "heard" that the pt "may have had a serious adverse event" and requested information regarding MMR II, encephalitis and coma. Unspecified medical attention was sought; however, the reporting physician noted that the pt was "not his pt." The reporter considered the adverse event to be an other important medical event. Additional info has been requested. Follow-up info was received on 06/27/02. The physician revealed that he is acting as a consutant on a legal case concerning this pt. He reported that she went on to develop encephalitis and later died. The reporter considered the encehalitis to be an other important medical event. Additional info has been requested.


Changed on 6/14/2018

VAERS ID: 187045 Before After
VAERS Form:1
Age:
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2002-07-05
Entered:2002-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -
TTOX: TETANUS TOXOID (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Coma, Encephalitis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Hospitalization
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0206USA01625

Write-up: Information has been received from a physician concerning a pt who was vaccinated with a dose of MMR II. The reporter "heard" that the pt "may have had a serious adverse event" and requested information regarding MMR II, encephalitis and coma. Unspecified medical attention was sought; however, the reporting physician noted that the pt was "not his pt." The reporter considered the adverse event to be an other important medical event. Additional info has been requested. Follow-up info was received on 06/27/02. The physician revealed that he is acting as a consutant on a legal case concerning this pt. He reported that she went on to develop encephalitis and later died. The reporter considered the encehalitis to be an other important medical event. Additional info has been requested.


Changed on 8/14/2018

VAERS ID: 187045 Before After
VAERS Form:1
Age:
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2002-07-05
Entered:2002-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -
TTOX: TETANUS TOXOID (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Coma, Encephalitis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Hospitalization
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0206USA01625

Write-up: Information has been received from a physician concerning a pt who was vaccinated with a dose of MMR II. The reporter "heard" that the pt "may have had a serious adverse event" and requested information regarding MMR II, encephalitis and coma. Unspecified medical attention was sought; however, the reporting physician noted that the pt was "not his pt." The reporter considered the adverse event to be an other important medical event. Additional info has been requested. Follow-up info was received on 06/27/02. The physician revealed that he is acting as a consutant on a legal case concerning this pt. He reported that she went on to develop encephalitis and later died. The reporter considered the encehalitis to be an other important medical event. Additional info has been requested.


Changed on 9/14/2018

VAERS ID: 187045 Before After
VAERS Form:1
Age:
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2002-07-05
Entered:2002-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -
TTOX: TETANUS TOXOID (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Coma, Encephalitis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Hospitalization
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0206USA01625

Write-up: Information has been received from a physician concerning a pt who was vaccinated with a dose of MMR II. The reporter "heard" that the pt "may have had a serious adverse event" and requested information regarding MMR II, encephalitis and coma. Unspecified medical attention was sought; however, the reporting physician noted that the pt was "not his pt." The reporter considered the adverse event to be an other important medical event. Additional info has been requested. Follow-up info was received on 06/27/02. The physician revealed that he is acting as a consutant on a legal case concerning this pt. He reported that she went on to develop encephalitis and later died. The reporter considered the encehalitis to be an other important medical event. Additional info has been requested.


Changed on 10/14/2018

VAERS ID: 187045 Before After
VAERS Form:1
Age:
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2002-07-05
Entered:2002-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -
TTOX: TETANUS TOXOID (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Coma, Encephalitis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Hospitalization
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0206USA01625

Write-up: Information has been received from a physician concerning a pt who was vaccinated with a dose of MMR II. The reporter "heard" that the pt "may have had a serious adverse event" and requested information regarding MMR II, encephalitis and coma. Unspecified medical attention was sought; however, the reporting physician noted that the pt was "not his pt." The reporter considered the adverse event to be an other important medical event. Additional info has been requested. Follow-up info was received on 06/27/02. The physician revealed that he is acting as a consutant on a legal case concerning this pt. He reported that she went on to develop encephalitis and later died. The reporter considered the encehalitis to be an other important medical event. Additional info has been requested.

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=187045&WAYBACKHISTORY=ON


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