National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 63044

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 63044
VAERS Form:
Age:6.3
Sex:Male
Location:New York
Vaccinated:1994-05-03
Onset:1994-05-06
Submitted:1994-05-16
Entered:1994-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II / MSD 0178A / - GM / -

Administered by: Private      Purchased by: Unknown
Symptoms: FEVER, DEHYDRAT, CONJUNCTIVITIS, ENCEPHALOPATHY, EDEMA BRAIN

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1994-05-07
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: pvt
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy-brain specimens sent for viral studies;
CDC 'Split Type':

Write-up: 2 days following inject pt devel OM & conjunctivitis w/fever; treated w/Augmentin; devel vomiting & dehydration 3 days p/vax; unexputed death autopsy showed brain edema;


Changed on 12/8/2009

VAERS ID: 63044 Before After
VAERS Form:
Age:6.3
Sex:Male
Location:New York
Vaccinated:1994-05-03
Onset:1994-05-06
Submitted:1994-05-16
Entered:1994-05-26 1994-05-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 0178A / - GM / -

Administered by: Private      Purchased by: Unknown Private
Symptoms: Conjunctivitis, Dehydration, Encephalopathy, Otitis media, Pyrexia, Vomiting, Brain oedema, FEVER, DEHYDRAT, CONJUNCTIVITIS, ENCEPHALOPATHY, EDEMA BRAIN

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1994-05-07
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: pvt
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy-brain specimens sent for viral studies;
CDC 'Split Type':

Write-up: 2 days following inject pt devel OM & conjunctivitis w/fever; treated w/Augmentin; devel vomiting & dehydration 3 days p/vax; unexputed death autopsy showed brain edema;


Changed on 2/14/2017

VAERS ID: 63044 Before After
VAERS Form:
Age:6.3 6.0
Sex:Male
Location:New York
Vaccinated:1994-05-03
Onset:1994-05-06
Submitted:1994-05-16
Entered:1994-05-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0178A / - GM / -

Administered by: Private      Purchased by: Private
Symptoms: Conjunctivitis, Dehydration, Encephalopathy, Otitis media, Pyrexia, Vomiting, Brain oedema

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1994-05-07
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: pvt
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy-brain specimens sent for viral studies;
CDC 'Split Type':

Write-up: 2 days following inject pt devel OM & conjunctivitis w/fever; treated w/Augmentin; devel vomiting & dehydration 3 days p/vax; unexputed death autopsy showed brain edema;


Changed on 5/14/2017

VAERS ID: 63044 Before After
VAERS Form:
Age:6.0
Sex:Male
Location:New York
Vaccinated:1994-05-03
Onset:1994-05-06
Submitted:1994-05-16
Entered:1994-05-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0178A / - GM / -

Administered by: Private      Purchased by: Private
Symptoms: Conjunctivitis, Dehydration, Encephalopathy, Otitis media, Pyrexia, Vomiting, Brain oedema

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1994-05-07
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: pvt
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy-brain specimens sent for viral studies;
CDC 'Split Type':

Write-up: 2 days following inject pt devel OM & conjunctivitis w/fever; treated w/Augmentin; devel vomiting & dehydration 3 days p/vax; unexputed death autopsy showed brain edema;


Changed on 9/14/2017

VAERS ID: 63044 Before After
VAERS Form:(blank) 1
Age:6.0
Sex:Male
Location:New York
Vaccinated:1994-05-03
Onset:1994-05-06
Submitted:1994-05-16
Entered:1994-05-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0178A / - UNK GM / -

Administered by: Private      Purchased by: Private
Symptoms: Conjunctivitis, Dehydration, Encephalopathy, Otitis media, Pyrexia, Vomiting, Brain oedema

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1994-05-07
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: pvt
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy-brain specimens sent for viral studies;
CDC 'Split Type':

Write-up: 2 days following inject pt devel OM & conjunctivitis w/fever; treated w/Augmentin; devel vomiting & dehydration 3 days p/vax; unexputed death autopsy showed brain edema;


Changed on 2/14/2018

VAERS ID: 63044 Before After
VAERS Form:1
Age:6.0
Sex:Male
Location:New York
Vaccinated:1994-05-03
Onset:1994-05-06
Submitted:1994-05-16
Entered:1994-05-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0178A / UNK GM / -

Administered by: Private      Purchased by: Private
Symptoms: Conjunctivitis, Dehydration, Encephalopathy, Otitis media, Pyrexia, Vomiting, Brain oedema

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1994-05-07
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: pvt
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy-brain specimens sent for viral studies;
CDC 'Split Type':

Write-up: 2 days following inject pt devel OM & conjunctivitis w/fever; treated w/Augmentin; devel vomiting & dehydration 3 days p/vax; unexputed death autopsy showed brain edema;


Changed on 6/14/2018

VAERS ID: 63044 Before After
VAERS Form:1
Age:6.0
Sex:Male
Location:New York
Vaccinated:1994-05-03
Onset:1994-05-06
Submitted:1994-05-16
Entered:1994-05-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0178A / UNK GM / -

Administered by: Private      Purchased by: Private
Symptoms: Conjunctivitis, Dehydration, Encephalopathy, Otitis media, Pyrexia, Vomiting, Brain oedema

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1994-05-07
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: pvt
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy-brain specimens sent for viral studies;
CDC 'Split Type':

Write-up: 2 days following inject pt devel OM & conjunctivitis w/fever; treated w/Augmentin; devel vomiting & dehydration 3 days p/vax; unexputed death autopsy showed brain edema;


Changed on 8/14/2018

VAERS ID: 63044 Before After
VAERS Form:1
Age:6.0
Sex:Male
Location:New York
Vaccinated:1994-05-03
Onset:1994-05-06
Submitted:1994-05-16
Entered:1994-05-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0178A / UNK GM / -

Administered by: Private      Purchased by: Private
Symptoms: Conjunctivitis, Dehydration, Encephalopathy, Otitis media, Pyrexia, Vomiting, Brain oedema

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1994-05-07
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: pvt
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy-brain specimens sent for viral studies;
CDC 'Split Type':

Write-up: 2 days following inject pt devel OM & conjunctivitis w/fever; treated w/Augmentin; devel vomiting & dehydration 3 days p/vax; unexputed death autopsy showed brain edema;


Changed on 9/14/2018

VAERS ID: 63044 Before After
VAERS Form:1
Age:6.0
Sex:Male
Location:New York
Vaccinated:1994-05-03
Onset:1994-05-06
Submitted:1994-05-16
Entered:1994-05-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0178A / UNK GM / -

Administered by: Private      Purchased by: Private
Symptoms: Conjunctivitis, Dehydration, Encephalopathy, Otitis media, Pyrexia, Vomiting, Brain oedema

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1994-05-07
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: pvt
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy-brain specimens sent for viral studies;
CDC 'Split Type':

Write-up: 2 days following inject pt devel OM & conjunctivitis w/fever; treated w/Augmentin; devel vomiting & dehydration 3 days p/vax; unexputed death autopsy showed brain edema;


Changed on 10/14/2018

VAERS ID: 63044 Before After
VAERS Form:1
Age:6.0
Sex:Male
Location:New York
Vaccinated:1994-05-03
Onset:1994-05-06
Submitted:1994-05-16
Entered:1994-05-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0178A / UNK GM / -

Administered by: Private      Purchased by: Private
Symptoms: Conjunctivitis, Dehydration, Encephalopathy, Otitis media, Pyrexia, Vomiting, Brain oedema

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1994-05-07
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: pvt
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy-brain specimens sent for viral studies;
CDC 'Split Type':

Write-up: 2 days following inject pt devel OM & conjunctivitis w/fever; treated w/Augmentin; devel vomiting & dehydration 3 days p/vax; unexputed death autopsy showed brain edema;

New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=63044&WAYBACKHISTORY=ON


Copyright © 2019 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166