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This is VAERS ID 62484

Case Details

VAERS ID: 62484 (history)  
Form: Version 1.0  
Age: 1.3  
Sex: Male  
Location: Foreign  
Vaccinated:1994-04-07
Onset:1994-04-15
   Days after vaccination:8
Submitted: 1994-05-06
   Days after onset:21
Entered: 1994-05-09
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1582W / UNK - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Anorexia, Infection, Lung disorder, Lymphadenopathy, Malaise, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness:
Preexisting Conditions: no relevant history;
Allergies:
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES94045034

Write-up: Pt recvd vax 7APR94 & 15APR94 the pt died suddenly; An autopsy is to be carried out to determine COD; Addtl info has been requested;


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