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This is VAERS ID 214715

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2004

VAERS ID: 214715
VAERS Form:
Age:
Sex:Unknown
Location:Unknown
Vaccinated:1998-06-02
Onset:0000-00-00
Submitted:2004-01-02
Entered:2004-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (UNKNOWN MFR) / UNKNOWN MFR - / - - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0238E / - - / -

Administered by: Other      Purchased by: Unknown
Symptoms: REACT UNEVAL

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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type':

Write-up: Information has been received from an attorney concerning a pt who on 6/2/98 was vaccinated with a dose of hep B virus vaccine. Other reported vaccinations included a dose of MMR II (620003/0238E). Subsequently the pt experienced death. The cause of death"was death unexplained. Additional info will be provided as it becomes available.


Changed on 12/8/2009

VAERS ID: 214715 Before After
VAERS Form:
Age:
Sex:Unknown
Location:Unknown
Vaccinated:1998-06-02
Onset:0000-00-00
Submitted:2004-01-02
Entered:2004-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (UNKNOWN MFR) HEP B (RECOMBIVAX HB) / UNKNOWN MFR MERCK & CO. INC. - / - - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0238E / - - / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Unevaluable event, REACT UNEVAL

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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': (blank) WAES0312USA02390

Write-up: Information has been received from an attorney concerning a pt who on 6/2/98 was vaccinated with a dose of hep B virus vaccine. Other reported vaccinations included a dose of MMR II (620003/0238E). Subsequently the pt experienced death. The cause of death"was death was death unexplained. Additional info will be provided as it becomes available.


Changed on 9/14/2017

VAERS ID: 214715 Before After
VAERS Form:(blank) 1
Age:
Sex:Unknown
Location:Unknown
Vaccinated:1998-06-02
Onset:0000-00-00
Submitted:2004-01-02
Entered:2004-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / - UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0238E / - UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Unevaluable event

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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0312USA02390

Write-up: Information has been received from an attorney concerning a pt who on 6/2/98 was vaccinated with a dose of hep B virus vaccine. Other reported vaccinations included a dose of MMR II (620003/0238E). Subsequently the pt experienced death. The cause of death was death unexplained. Additional info will be provided as it becomes available.


Changed on 2/14/2018

VAERS ID: 214715 Before After
VAERS Form:1
Age:
Sex:Unknown
Location:Unknown
Vaccinated:1998-06-02
Onset:0000-00-00
Submitted:2004-01-02
Entered:2004-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0238E / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Unevaluable event

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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0312USA02390

Write-up: Information has been received from an attorney concerning a pt who on 6/2/98 was vaccinated with a dose of hep B virus vaccine. Other reported vaccinations included a dose of MMR II (620003/0238E). Subsequently the pt experienced death. The cause of death was death unexplained. Additional info will be provided as it becomes available.


Changed on 6/14/2018

VAERS ID: 214715 Before After
VAERS Form:1
Age:
Sex:Unknown
Location:Unknown
Vaccinated:1998-06-02
Onset:0000-00-00
Submitted:2004-01-02
Entered:2004-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0238E / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Unevaluable event

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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0312USA02390

Write-up: Information has been received from an attorney concerning a pt who on 6/2/98 was vaccinated with a dose of hep B virus vaccine. Other reported vaccinations included a dose of MMR II (620003/0238E). Subsequently the pt experienced death. The cause of death was death unexplained. Additional info will be provided as it becomes available.


Changed on 8/14/2018

VAERS ID: 214715 Before After
VAERS Form:1
Age:
Sex:Unknown
Location:Unknown
Vaccinated:1998-06-02
Onset:0000-00-00
Submitted:2004-01-02
Entered:2004-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0238E / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Unevaluable event

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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0312USA02390

Write-up: Information has been received from an attorney concerning a pt who on 6/2/98 was vaccinated with a dose of hep B virus vaccine. Other reported vaccinations included a dose of MMR II (620003/0238E). Subsequently the pt experienced death. The cause of death was death unexplained. Additional info will be provided as it becomes available.


Changed on 9/14/2018

VAERS ID: 214715 Before After
VAERS Form:1
Age:
Sex:Unknown
Location:Unknown
Vaccinated:1998-06-02
Onset:0000-00-00
Submitted:2004-01-02
Entered:2004-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0238E / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Unevaluable event

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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0312USA02390

Write-up: Information has been received from an attorney concerning a pt who on 6/2/98 was vaccinated with a dose of hep B virus vaccine. Other reported vaccinations included a dose of MMR II (620003/0238E). Subsequently the pt experienced death. The cause of death was death unexplained. Additional info will be provided as it becomes available.


Changed on 10/14/2018

VAERS ID: 214715 Before After
VAERS Form:1
Age:
Sex:Unknown
Location:Unknown
Vaccinated:1998-06-02
Onset:0000-00-00
Submitted:2004-01-02
Entered:2004-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0238E / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Unevaluable event

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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0312USA02390

Write-up: Information has been received from an attorney concerning a pt who on 6/2/98 was vaccinated with a dose of hep B virus vaccine. Other reported vaccinations included a dose of MMR II (620003/0238E). Subsequently the pt experienced death. The cause of death was death unexplained. Additional info will be provided as it becomes available.

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=214715&WAYBACKHISTORY=ON


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