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This is VAERS ID 72450

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 72450
VAERS Form:
Age:1.3
Sex:Male
Location:Foreign
Vaccinated:1995-02-20
Onset:1995-02-21
Submitted:1995-03-23
Entered:1995-03-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DT: DT ADSORBED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Agitation, Bronchitis, Cough, Infection, Pneumonia, Pyrexia, Sepsis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1995-02-22
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: cough syrup
Current Illness:
Preexisting Conditions: no relevant history
Allergies:
Diagnostic Lab Data: blood test-streptococcus pneumonia;
CDC 'Split Type': WAES95030780

Write-up: pt recvd vax & had a sl cough & cough medicine was prescribed; On 21FEB95 & exp fever of 38.6 to 38.7; 22FEB95 woke in the morning crying; went to sleep again 1hr later found dead; tracheobronchitis; streptococcus pneumonia, type 10A found


Changed on 5/14/2017

VAERS ID: 72450 Before After
VAERS Form:
Age:1.3
Sex:Male
Location:Foreign
Vaccinated:1995-02-20
Onset:1995-02-21
Submitted:1995-03-23
Entered:1995-03-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DT: DT ADSORBED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Agitation, Bronchitis, Cough, Infection, Pneumonia, Pyrexia, Sepsis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1995-02-22
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: cough syrup
Current Illness:
Preexisting Conditions: no relevant history
Allergies:
Diagnostic Lab Data: blood test-streptococcus pneumonia;
CDC 'Split Type': WAES95030780

Write-up: pt recvd vax & had a sl cough & cough medicine was prescribed; On 21FEB95 & exp fever of 38.6 to 38.7; 22FEB95 woke in the morning crying; went to sleep again 1hr later found dead; tracheobronchitis; streptococcus pneumonia, type 10A found


Changed on 9/14/2017

VAERS ID: 72450 Before After
VAERS Form:(blank) 1
Age:1.3
Sex:Male
Location:Foreign
Vaccinated:1995-02-20
Onset:1995-02-21
Submitted:1995-03-23
Entered:1995-03-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DT: DT ADSORBED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK - / -
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / - UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Agitation, Bronchitis, Cough, Infection, Pneumonia, Pyrexia, Sepsis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1995-02-22
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: cough syrup
Current Illness:
Preexisting Conditions: no relevant history
Allergies:
Diagnostic Lab Data: blood test-streptococcus pneumonia;
CDC 'Split Type': WAES95030780

Write-up: pt recvd vax & had a sl cough & cough medicine was prescribed; On 21FEB95 & exp fever of 38.6 to 38.7; 22FEB95 woke in the morning crying; went to sleep again 1hr later found dead; tracheobronchitis; streptococcus pneumonia, type 10A found


Changed on 2/14/2018

VAERS ID: 72450 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:Foreign
Vaccinated:1995-02-20
Onset:1995-02-21
Submitted:1995-03-23
Entered:1995-03-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DT: DT ADSORBED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Agitation, Bronchitis, Cough, Infection, Pneumonia, Pyrexia, Sepsis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1995-02-22
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: cough syrup
Current Illness:
Preexisting Conditions: no relevant history
Allergies:
Diagnostic Lab Data: blood test-streptococcus pneumonia;
CDC 'Split Type': WAES95030780

Write-up: pt recvd vax & had a sl cough & cough medicine was prescribed; On 21FEB95 & exp fever of 38.6 to 38.7; 22FEB95 woke in the morning crying; went to sleep again 1hr later found dead; tracheobronchitis; streptococcus pneumonia, type 10A found


Changed on 6/14/2018

VAERS ID: 72450 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:Foreign
Vaccinated:1995-02-20
Onset:1995-02-21
Submitted:1995-03-23
Entered:1995-03-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DT: DT ADSORBED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Agitation, Bronchitis, Cough, Infection, Pneumonia, Pyrexia, Sepsis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1995-02-22
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: cough syrup
Current Illness:
Preexisting Conditions: no relevant history
Allergies:
Diagnostic Lab Data: blood test-streptococcus pneumonia;
CDC 'Split Type': WAES95030780

Write-up: pt recvd vax & had a sl cough & cough medicine was prescribed; On 21FEB95 & exp fever of 38.6 to 38.7; 22FEB95 woke in the morning crying; went to sleep again 1hr later found dead; tracheobronchitis; streptococcus pneumonia, type 10A found


Changed on 8/14/2018

VAERS ID: 72450 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:Foreign
Vaccinated:1995-02-20
Onset:1995-02-21
Submitted:1995-03-23
Entered:1995-03-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DT: DT ADSORBED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Agitation, Bronchitis, Cough, Infection, Pneumonia, Pyrexia, Sepsis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1995-02-22
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: cough syrup
Current Illness:
Preexisting Conditions: no relevant history
Allergies:
Diagnostic Lab Data: blood test-streptococcus pneumonia;
CDC 'Split Type': WAES95030780

Write-up: pt recvd vax & had a sl cough & cough medicine was prescribed; On 21FEB95 & exp fever of 38.6 to 38.7; 22FEB95 woke in the morning crying; went to sleep again 1hr later found dead; tracheobronchitis; streptococcus pneumonia, type 10A found


Changed on 9/14/2018

VAERS ID: 72450 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:Foreign
Vaccinated:1995-02-20
Onset:1995-02-21
Submitted:1995-03-23
Entered:1995-03-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DT: DT ADSORBED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Agitation, Bronchitis, Cough, Infection, Pneumonia, Pyrexia, Sepsis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1995-02-22
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: cough syrup
Current Illness:
Preexisting Conditions: no relevant history
Allergies:
Diagnostic Lab Data: blood test-streptococcus pneumonia;
CDC 'Split Type': WAES95030780

Write-up: pt recvd vax & had a sl cough & cough medicine was prescribed; On 21FEB95 & exp fever of 38.6 to 38.7; 22FEB95 woke in the morning crying; went to sleep again 1hr later found dead; tracheobronchitis; streptococcus pneumonia, type 10A found


Changed on 10/14/2018

VAERS ID: 72450 Before After
VAERS Form:1
Age:1.3
Sex:Male
Location:Foreign
Vaccinated:1995-02-20
Onset:1995-02-21
Submitted:1995-03-23
Entered:1995-03-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DT: DT ADSORBED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Agitation, Bronchitis, Cough, Infection, Pneumonia, Pyrexia, Sepsis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1995-02-22
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: cough syrup
Current Illness:
Preexisting Conditions: no relevant history
Allergies:
Diagnostic Lab Data: blood test-streptococcus pneumonia;
CDC 'Split Type': WAES95030780

Write-up: pt recvd vax & had a sl cough & cough medicine was prescribed; On 21FEB95 & exp fever of 38.6 to 38.7; 22FEB95 woke in the morning crying; went to sleep again 1hr later found dead; tracheobronchitis; streptococcus pneumonia, type 10A found

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=72450&WAYBACKHISTORY=ON


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