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This is VAERS ID 27526

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 27526
VAERS Form:
Age:0.5
Sex:Female
Location:Michigan
Vaccinated:1990-12-22
Onset:1990-12-31
Submitted:0000-00-00
Entered:1991-01-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
M: ATTENUVAX / MSD - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: CONVULS, FEVER, APNEA, BRONCHITIS, COAGUL DIS

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: On 31DEC90 experienced shock, renal failure, fever, convuls & pneumonia. Hospitalized & lab testing revealed a positive assay for toxic shock synd, septic shock, & disseminated intravascular coagulation. MD stated pt''s sxs not d/t vaccinatn


Changed on 12/8/2009

VAERS ID: 27526 Before After
VAERS Form:
Age:0.5
Sex:Female
Location:Michigan
Vaccinated:1990-12-22
Onset:1990-12-31
Submitted:0000-00-00
Entered:1991-01-25 1991-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
M: ATTENUVAX / MSD - / - - / -
MEA: MEASLES (ATTENUVAX) / MERCK & CO. INC. - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Bronchitis, Cardiac failure, Coagulopathy, Convulsion, Infection, Pharyngitis, Pneumonia, Pyrexia, Rash, Renal failure, Sepsis, Shock, CONVULS, FEVER, APNEA, BRONCHITIS, COAGUL DIS

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) WAES91010158

Write-up: On 31DEC90 experienced shock, renal failure, fever, convuls & pneumonia. Hospitalized & lab testing revealed a positive assay for toxic shock synd, septic shock, & disseminated intravascular coagulation. MD stated pt''s sxs not d/t vaccinatn


Changed on 5/14/2017

VAERS ID: 27526 Before After
VAERS Form:
Age:0.5
Sex:Female
Location:Michigan
Vaccinated:1990-12-22
Onset:1990-12-31
Submitted:0000-00-00
Entered:1991-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEA: MEASLES (ATTENUVAX) / MERCK & CO. INC. - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Bronchitis, Cardiac failure, Coagulopathy, Convulsion, Infection, Pharyngitis, Pneumonia, Pyrexia, Rash, Renal failure, Sepsis, Shock

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES91010158

Write-up: On 31DEC90 experienced Developed T,convuls&pneumonia.Hospitalized w/ septic shock, renal failure, fever, convuls & pneumonia. Hospitalized & lab testing revealed a positive assay for toxic shock synd, septic shock, failure & disseminated intravascular coagulation. MD stated pt''s sxs not d/t vaccinatn coagulation.Develop rash&tracheitis.Culture-Staph aureus.Exp multiple system failure-renal/respiratory/metabolic/cardivascul.Died 11Jan91


Changed on 9/14/2017

VAERS ID: 27526 Before After
VAERS Form:(blank) 1
Age:0.5
Sex:Female
Location:Michigan
Vaccinated:1990-12-22
Onset:1990-12-31
Submitted:0000-00-00
Entered:1991-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEA: MEASLES (ATTENUVAX) / MERCK & CO. INC. - / - UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Bronchitis, Cardiac failure, Coagulopathy, Convulsion, Infection, Pharyngitis, Pneumonia, Pyrexia, Rash, Renal failure, Sepsis, Shock

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES91010158

Write-up: Developed T,convuls&pneumonia.Hospitalized w/ septic shock, renal failure & disseminated intravascular coagulation.Develop rash&tracheitis.Culture-Staph aureus.Exp multiple system failure-renal/respiratory/metabolic/cardivascul.Died 11Jan91


Changed on 2/14/2018

VAERS ID: 27526 Before After
VAERS Form:1
Age:0.5
Sex:Female
Location:Michigan
Vaccinated:1990-12-22
Onset:1990-12-31
Submitted:0000-00-00
Entered:1991-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEA: MEASLES (ATTENUVAX) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Bronchitis, Cardiac failure, Coagulopathy, Convulsion, Infection, Pharyngitis, Pneumonia, Pyrexia, Rash, Renal failure, Sepsis, Shock

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES91010158

Write-up: Developed T,convuls&pneumonia.Hospitalized w/ septic shock, renal failure & disseminated intravascular coagulation.Develop rash&tracheitis.Culture-Staph aureus.Exp multiple system failure-renal/respiratory/metabolic/cardivascul.Died 11Jan91


Changed on 6/14/2018

VAERS ID: 27526 Before After
VAERS Form:1
Age:0.5
Sex:Female
Location:Michigan
Vaccinated:1990-12-22
Onset:1990-12-31
Submitted:0000-00-00
Entered:1991-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEA: MEASLES (ATTENUVAX) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Bronchitis, Cardiac failure, Coagulopathy, Convulsion, Infection, Pharyngitis, Pneumonia, Pyrexia, Rash, Renal failure, Sepsis, Shock

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES91010158

Write-up: Developed T,convuls&pneumonia.Hospitalized w/ septic shock, renal failure & disseminated intravascular coagulation.Develop rash&tracheitis.Culture-Staph aureus.Exp multiple system failure-renal/respiratory/metabolic/cardivascul.Died 11Jan91


Changed on 8/14/2018

VAERS ID: 27526 Before After
VAERS Form:1
Age:0.5
Sex:Female
Location:Michigan
Vaccinated:1990-12-22
Onset:1990-12-31
Submitted:0000-00-00
Entered:1991-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEA: MEASLES (ATTENUVAX) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Bronchitis, Cardiac failure, Coagulopathy, Convulsion, Infection, Pharyngitis, Pneumonia, Pyrexia, Rash, Renal failure, Sepsis, Shock

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES91010158

Write-up: Developed T,convuls&pneumonia.Hospitalized w/ septic shock, renal failure & disseminated intravascular coagulation.Develop rash&tracheitis.Culture-Staph aureus.Exp multiple system failure-renal/respiratory/metabolic/cardivascul.Died 11Jan91


Changed on 9/14/2018

VAERS ID: 27526 Before After
VAERS Form:1
Age:0.5
Sex:Female
Location:Michigan
Vaccinated:1990-12-22
Onset:1990-12-31
Submitted:0000-00-00
Entered:1991-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEA: MEASLES (ATTENUVAX) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Bronchitis, Cardiac failure, Coagulopathy, Convulsion, Infection, Pharyngitis, Pneumonia, Pyrexia, Rash, Renal failure, Sepsis, Shock

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES91010158

Write-up: Developed T,convuls&pneumonia.Hospitalized w/ septic shock, renal failure & disseminated intravascular coagulation.Develop rash&tracheitis.Culture-Staph aureus.Exp multiple system failure-renal/respiratory/metabolic/cardivascul.Died 11Jan91


Changed on 10/14/2018

VAERS ID: 27526 Before After
VAERS Form:1
Age:0.5
Sex:Female
Location:Michigan
Vaccinated:1990-12-22
Onset:1990-12-31
Submitted:0000-00-00
Entered:1991-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEA: MEASLES (ATTENUVAX) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Bronchitis, Cardiac failure, Coagulopathy, Convulsion, Infection, Pharyngitis, Pneumonia, Pyrexia, Rash, Renal failure, Sepsis, Shock

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES91010158

Write-up: Developed T,convuls&pneumonia.Hospitalized w/ septic shock, renal failure & disseminated intravascular coagulation.Develop rash&tracheitis.Culture-Staph aureus.Exp multiple system failure-renal/respiratory/metabolic/cardivascul.Died 11Jan91

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