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This is VAERS ID 37777

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 37777
VAERS Form:
Age:0.1
Sex:Male
Location:New York
Vaccinated:1991-07-08
Onset:1991-11-04
Submitted:1991-12-02
Entered:1991-12-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: RECOMBIVAX HB / MSD 1581S / 1 - / -

Administered by: Private      Purchased by: Unknown
Symptoms: INFECT, HEPATITIS, COMA, COAGUL DIS, ASCITES

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1991-11-12
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: 9     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: Mom HBAg positive;
Allergies:
Diagnostic Lab Data: No relevant data
CDC 'Split Type':

Write-up: Pt recvd 2nd dose of Hep B vax @ one month of age; subsequently, pt devel fulminant Hep B & was hospitalized for a liver transplant; In mid-November 91, pt died @ 5 months of age;


Changed on 12/8/2009

VAERS ID: 37777 Before After
VAERS Form:
Age:0.1
Sex:Male
Location:New York
Vaccinated:1991-07-08
Onset:1991-11-04
Submitted:1991-12-02
Entered:1991-12-06 1991-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: RECOMBIVAX HB HEP B (RECOMBIVAX HB) / MSD MERCK & CO. INC. 1581S / 1 - / -

Administered by: Private      Purchased by: Unknown Other
Symptoms: Ascites, Coagulopathy, Coma, Hepatic failure, Hepatic necrosis, Hepatitis, Infection, Intracranial pressure increased, INFECT, HEPATITIS, COMA, COAGUL DIS, ASCITES

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1991-11-12
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: 9     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: Mom HBAg positive;
Allergies:
Diagnostic Lab Data: No relevant data
CDC 'Split Type': (blank) WAES91110702

Write-up: Pt recvd 2nd dose of Hep B vax @ one month of age; subsequently, pt devel fulminant Hep B & was hospitalized for a liver transplant; In mid-November 91, pt died @ 5 months of age;


Changed on 5/14/2017

VAERS ID: 37777 Before After
VAERS Form:
Age:0.1
Sex:Male
Location:New York
Vaccinated:1991-07-08
Onset:1991-11-04
Submitted:1991-12-02
Entered:1991-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1581S / 1 - / -

Administered by: Private      Purchased by: Other
Symptoms: Ascites, Coagulopathy, Coma, Hepatic failure, Hepatic necrosis, Hepatitis, Infection, Intracranial pressure increased

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1991-11-12
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: 9     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: None
Current Illness:
Preexisting Conditions: Mom HBAg positive;
Allergies:
Diagnostic Lab Data: No relevant data
CDC 'Split Type': WAES91110702

Write-up: Pt recvd 2nd dose of Hep B vax @ one month of age; subsequently, pt devel fulminant Hep B & was hospitalized for a liver transplant; In mid-November 91, pt died @ 5 months of age;


Changed on 9/14/2017

VAERS ID: 37777 Before After
VAERS Form:(blank) 1
Age:0.1
Sex:Male
Location:New York
Vaccinated:1991-07-08
Onset:1991-11-04
Submitted:1991-12-02
Entered:1991-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1581S / 1 2 - / -

Administered by: Private      Purchased by: Other
Symptoms: Ascites, Coagulopathy, Coma, Hepatic failure, Hepatic necrosis, Hepatitis, Infection, Intracranial pressure increased

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1991-11-12
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: 9     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: None
Current Illness:
Preexisting Conditions: Mom HBAg positive;
Allergies:
Diagnostic Lab Data: No relevant data
CDC 'Split Type': WAES91110702

Write-up: Pt recvd 2nd dose of Hep B vax @ one month of age; subsequently, pt devel fulminant Hep B & was hospitalized for a liver transplant; In mid-November 91, pt died @ 5 months of age;


Changed on 2/14/2018

VAERS ID: 37777 Before After
VAERS Form:1
Age:0.1
Sex:Male
Location:New York
Vaccinated:1991-07-08
Onset:1991-11-04
Submitted:1991-12-02
Entered:1991-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1581S / 2 - / -

Administered by: Private      Purchased by: Other
Symptoms: Ascites, Coagulopathy, Coma, Hepatic failure, Hepatic necrosis, Hepatitis, Infection, Intracranial pressure increased

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1991-11-12
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: 9     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: None
Current Illness:
Preexisting Conditions: Mom HBAg positive;
Allergies:
Diagnostic Lab Data: No relevant data
CDC 'Split Type': WAES91110702

Write-up: Pt recvd 2nd dose of Hep B vax @ one month of age; subsequently, pt devel fulminant Hep B & was hospitalized for a liver transplant; In mid-November 91, pt died @ 5 months of age;


Changed on 6/14/2018

VAERS ID: 37777 Before After
VAERS Form:1
Age:0.1
Sex:Male
Location:New York
Vaccinated:1991-07-08
Onset:1991-11-04
Submitted:1991-12-02
Entered:1991-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1581S / 2 - / -

Administered by: Private      Purchased by: Other
Symptoms: Ascites, Coagulopathy, Coma, Hepatic failure, Hepatic necrosis, Hepatitis, Infection, Intracranial pressure increased

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1991-11-12
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: 9     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: None
Current Illness:
Preexisting Conditions: Mom HBAg positive;
Allergies:
Diagnostic Lab Data: No relevant data
CDC 'Split Type': WAES91110702

Write-up: Pt recvd 2nd dose of Hep B vax @ one month of age; subsequently, pt devel fulminant Hep B & was hospitalized for a liver transplant; In mid-November 91, pt died @ 5 months of age;


Changed on 8/14/2018

VAERS ID: 37777 Before After
VAERS Form:1
Age:0.1
Sex:Male
Location:New York
Vaccinated:1991-07-08
Onset:1991-11-04
Submitted:1991-12-02
Entered:1991-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1581S / 2 - / -

Administered by: Private      Purchased by: Other
Symptoms: Ascites, Coagulopathy, Coma, Hepatic failure, Hepatic necrosis, Hepatitis, Infection, Intracranial pressure increased

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1991-11-12
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: 9     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: None
Current Illness:
Preexisting Conditions: Mom HBAg positive;
Allergies:
Diagnostic Lab Data: No relevant data
CDC 'Split Type': WAES91110702

Write-up: Pt recvd 2nd dose of Hep B vax @ one month of age; subsequently, pt devel fulminant Hep B & was hospitalized for a liver transplant; In mid-November 91, pt died @ 5 months of age;


Changed on 9/14/2018

VAERS ID: 37777 Before After
VAERS Form:1
Age:0.1
Sex:Male
Location:New York
Vaccinated:1991-07-08
Onset:1991-11-04
Submitted:1991-12-02
Entered:1991-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1581S / 2 - / -

Administered by: Private      Purchased by: Other
Symptoms: Ascites, Coagulopathy, Coma, Hepatic failure, Hepatic necrosis, Hepatitis, Infection, Intracranial pressure increased

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1991-11-12
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: 9     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: None
Current Illness:
Preexisting Conditions: Mom HBAg positive;
Allergies:
Diagnostic Lab Data: No relevant data
CDC 'Split Type': WAES91110702

Write-up: Pt recvd 2nd dose of Hep B vax @ one month of age; subsequently, pt devel fulminant Hep B & was hospitalized for a liver transplant; In mid-November 91, pt died @ 5 months of age;


Changed on 10/14/2018

VAERS ID: 37777 Before After
VAERS Form:1
Age:0.1
Sex:Male
Location:New York
Vaccinated:1991-07-08
Onset:1991-11-04
Submitted:1991-12-02
Entered:1991-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1581S / 2 - / -

Administered by: Private      Purchased by: Other
Symptoms: Ascites, Coagulopathy, Coma, Hepatic failure, Hepatic necrosis, Hepatitis, Infection, Intracranial pressure increased

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1991-11-12
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: 9     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: None
Current Illness:
Preexisting Conditions: Mom HBAg positive;
Allergies:
Diagnostic Lab Data: No relevant data
CDC 'Split Type': WAES91110702

Write-up: Pt recvd 2nd dose of Hep B vax @ one month of age; subsequently, pt devel fulminant Hep B & was hospitalized for a liver transplant; In mid-November 91, pt died @ 5 months of age;

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