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This is VAERS ID 53621

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 53621
VAERS Form:
Age:1.6
Sex:Female
Location:New York
Vaccinated:1982-02-09
Onset:1982-02-23
Submitted:1993-06-04
Entered:1993-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II / MSD - / - - / -

Administered by: Other      Purchased by: Unknown
Symptoms: DEHYDRAT, HEART ARREST, EDEMA BRAIN, COMA DIABET, IMPACT FECAL

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1982-04-08
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: common cold; Roseola;
Allergies:
Diagnostic Lab Data: 8APR82 Autopsy-death determined to be diabetic ketoacidosis & coma; pancreas found to be virus infected;
CDC 'Split Type':

Write-up: pt recvd vax 9FEB82 & on 23FEB82 devel diabetic sx: excessive urination & thirst; parents did not recognize sx until pt went into coma 7APR92 following day pt died; pt was dehydrated w/early fecal impaction, pancreatic edema; cerebral edema


Changed on 12/8/2009

VAERS ID: 53621 Before After
VAERS Form:
Age:1.6
Sex:Female
Location:New York
Vaccinated:1982-02-09
Onset:1982-02-23
Submitted:1993-06-04
Entered:1993-06-09 1993-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. - / - - / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Cardiac arrest, Dehydration, Diabetic coma, Infection, Ketosis, Pancreatic disorder, Brain oedema, Faecaloma, DEHYDRAT, HEART ARREST, EDEMA BRAIN, COMA DIABET, IMPACT FECAL

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1982-04-08
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: common cold; Roseola;
Allergies:
Diagnostic Lab Data: 8APR82 Autopsy-death determined to be diabetic ketoacidosis & coma; pancreas found to be virus infected;
CDC 'Split Type': (blank) WAES93050798

Write-up: pt recvd vax 9FEB82 & on 23FEB82 devel diabetic sx: excessive urination & thirst; parents did not recognize sx until pt went into coma 7APR92 following day pt died; pt was dehydrated w/early fecal impaction, pancreatic edema; cerebral edema


Changed on 5/14/2017

VAERS ID: 53621 Before After
VAERS Form:
Age:1.6
Sex:Female
Location:New York
Vaccinated:1982-02-09
Onset:1982-02-23
Submitted:1993-06-04
Entered:1993-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / - - / -

Administered by: Other      Purchased by: Other
Symptoms: Cardiac arrest, Dehydration, Diabetic coma, Infection, Ketosis, Pancreatic disorder, Brain oedema, Faecaloma

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1982-04-08
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:
Current Illness:
Preexisting Conditions: common cold; Roseola;
Allergies:
Diagnostic Lab Data: 8APR82 Autopsy-death determined to be diabetic ketoacidosis & coma; pancreas found to be virus infected;
CDC 'Split Type': WAES93050798

Write-up: pt recvd vax 9FEB82 & on 23FEB82 devel diabetic sx: excessive urination & thirst; parents did not recognize sx until pt went into coma 7APR92 following day pt died; pt was dehydrated w/early fecal impaction, pancreatic edema; cerebral edema


Changed on 9/14/2017

VAERS ID: 53621 Before After
VAERS Form:(blank) 1
Age:1.6
Sex:Female
Location:New York
Vaccinated:1982-02-09
Onset:1982-02-23
Submitted:1993-06-04
Entered:1993-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / - UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Cardiac arrest, Dehydration, Diabetic coma, Infection, Ketosis, Pancreatic disorder, Brain oedema, Faecaloma

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1982-04-08
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:
Current Illness:
Preexisting Conditions: common cold; Roseola;
Allergies:
Diagnostic Lab Data: 8APR82 Autopsy-death determined to be diabetic ketoacidosis & coma; pancreas found to be virus infected;
CDC 'Split Type': WAES93050798

Write-up: pt recvd vax 9FEB82 & on 23FEB82 devel diabetic sx: excessive urination & thirst; parents did not recognize sx until pt went into coma 7APR92 following day pt died; pt was dehydrated w/early fecal impaction, pancreatic edema; cerebral edema


Changed on 2/14/2018

VAERS ID: 53621 Before After
VAERS Form:1
Age:1.6
Sex:Female
Location:New York
Vaccinated:1982-02-09
Onset:1982-02-23
Submitted:1993-06-04
Entered:1993-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Cardiac arrest, Dehydration, Diabetic coma, Infection, Ketosis, Pancreatic disorder, Brain oedema, Faecaloma

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1982-04-08
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:
Current Illness:
Preexisting Conditions: common cold; Roseola;
Allergies:
Diagnostic Lab Data: 8APR82 Autopsy-death determined to be diabetic ketoacidosis & coma; pancreas found to be virus infected;
CDC 'Split Type': WAES93050798

Write-up: pt recvd vax 9FEB82 & on 23FEB82 devel diabetic sx: excessive urination & thirst; parents did not recognize sx until pt went into coma 7APR92 following day pt died; pt was dehydrated w/early fecal impaction, pancreatic edema; cerebral edema


Changed on 6/14/2018

VAERS ID: 53621 Before After
VAERS Form:1
Age:1.6
Sex:Female
Location:New York
Vaccinated:1982-02-09
Onset:1982-02-23
Submitted:1993-06-04
Entered:1993-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Cardiac arrest, Dehydration, Diabetic coma, Infection, Ketosis, Pancreatic disorder, Brain oedema, Faecaloma

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1982-04-08
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:
Current Illness:
Preexisting Conditions: common cold; Roseola;
Allergies:
Diagnostic Lab Data: 8APR82 Autopsy-death determined to be diabetic ketoacidosis & coma; pancreas found to be virus infected;
CDC 'Split Type': WAES93050798

Write-up: pt recvd vax 9FEB82 & on 23FEB82 devel diabetic sx: excessive urination & thirst; parents did not recognize sx until pt went into coma 7APR92 following day pt died; pt was dehydrated w/early fecal impaction, pancreatic edema; cerebral edema


Changed on 8/14/2018

VAERS ID: 53621 Before After
VAERS Form:1
Age:1.6
Sex:Female
Location:New York
Vaccinated:1982-02-09
Onset:1982-02-23
Submitted:1993-06-04
Entered:1993-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Cardiac arrest, Dehydration, Diabetic coma, Infection, Ketosis, Pancreatic disorder, Brain oedema, Faecaloma

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1982-04-08
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:
Current Illness:
Preexisting Conditions: common cold; Roseola;
Allergies:
Diagnostic Lab Data: 8APR82 Autopsy-death determined to be diabetic ketoacidosis & coma; pancreas found to be virus infected;
CDC 'Split Type': WAES93050798

Write-up: pt recvd vax 9FEB82 & on 23FEB82 devel diabetic sx: excessive urination & thirst; parents did not recognize sx until pt went into coma 7APR92 following day pt died; pt was dehydrated w/early fecal impaction, pancreatic edema; cerebral edema


Changed on 9/14/2018

VAERS ID: 53621 Before After
VAERS Form:1
Age:1.6
Sex:Female
Location:New York
Vaccinated:1982-02-09
Onset:1982-02-23
Submitted:1993-06-04
Entered:1993-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Cardiac arrest, Dehydration, Diabetic coma, Infection, Ketosis, Pancreatic disorder, Brain oedema, Faecaloma

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1982-04-08
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:
Current Illness:
Preexisting Conditions: common cold; Roseola;
Allergies:
Diagnostic Lab Data: 8APR82 Autopsy-death determined to be diabetic ketoacidosis & coma; pancreas found to be virus infected;
CDC 'Split Type': WAES93050798

Write-up: pt recvd vax 9FEB82 & on 23FEB82 devel diabetic sx: excessive urination & thirst; parents did not recognize sx until pt went into coma 7APR92 following day pt died; pt was dehydrated w/early fecal impaction, pancreatic edema; cerebral edema


Changed on 10/14/2018

VAERS ID: 53621 Before After
VAERS Form:1
Age:1.6
Sex:Female
Location:New York
Vaccinated:1982-02-09
Onset:1982-02-23
Submitted:1993-06-04
Entered:1993-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Cardiac arrest, Dehydration, Diabetic coma, Infection, Ketosis, Pancreatic disorder, Brain oedema, Faecaloma

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1982-04-08
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:
Current Illness:
Preexisting Conditions: common cold; Roseola;
Allergies:
Diagnostic Lab Data: 8APR82 Autopsy-death determined to be diabetic ketoacidosis & coma; pancreas found to be virus infected;
CDC 'Split Type': WAES93050798

Write-up: pt recvd vax 9FEB82 & on 23FEB82 devel diabetic sx: excessive urination & thirst; parents did not recognize sx until pt went into coma 7APR92 following day pt died; pt was dehydrated w/early fecal impaction, pancreatic edema; cerebral edema

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