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This is VAERS ID 25010

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

25010
VAERS Form:
Age:1.7
Gender:Male
Location:Foreign
Vaccinated:1989-10-29
Onset:1989-12-01
Submitted:0000-00-00
Entered:1990-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. A2223P / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Bronchitis

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: Promethanzine HCL given 21Dec89-21Dec89
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Dianostic test - Autopsy, Date Dec89 , comment - Streptococcal tracheobronchitis
CDC 'Split Type': WAES90060362

Write-up:17 mon. male, received 29Oct89 MMR vaccine 1 dose. 21Dec89 received therapy w/ Promethazine HCL, HS. 22Dec89 infant found dead. Post mortem revealed acute Streptococcal tracheobronchitis.


Changed on 5/14/2017

25010 Before After
VAERS Form:
Age:1.7
Gender:Male
Location:Foreign
Vaccinated:1989-10-29
Onset:1989-12-01
Submitted:0000-00-00
Entered:1990-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. A2223P / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Bronchitis

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: ~ ()~~~In patient
Other Medications: Promethanzine HCL given 21Dec89-21Dec89
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Dianostic test - Autopsy, Date Dec89 , comment - Streptococcal tracheobronchitis
CDC 'Split Type': WAES90060362

Write-up:17 mon. male, received 29Oct89 MMR vaccine 1 dose. 21Dec89 received therapy w/ Promethazine HCL, HS. 22Dec89 infant found dead. Post mortem revealed acute Streptococcal tracheobronchitis.


Changed on 9/14/2017

25010 Before After
VAERS Form:(blank) 1
Age:1.7
Gender:Male
Location:Foreign
Vaccinated:1989-10-29
Onset:1989-12-01
Submitted:0000-00-00
Entered:1990-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. A2223P / - UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Bronchitis

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: ~ ()~~~In patient
Other Medications: Promethanzine HCL given 21Dec89-21Dec89
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Dianostic test - Autopsy, Date Dec89 , comment - Streptococcal tracheobronchitis
CDC 'Split Type': WAES90060362

Write-up:17 mon. male, received 29Oct89 MMR vaccine 1 dose. 21Dec89 received therapy w/ Promethazine HCL, HS. 22Dec89 infant found dead. Post mortem revealed acute Streptococcal tracheobronchitis.


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