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This is VAERS ID 76575

Case Details

VAERS ID: 76575 (history)  
Form: Version 1.0  
Age: 1.0  
Sex: Male  
Location: Foreign  
Vaccinated:1995-06-27
Onset:1995-07-02
   Days after vaccination:5
Submitted: 1995-08-02
   Days after onset:31
Entered: 1995-08-08
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Coagulopathy, Hepatic cirrhosis
SMQs:, Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Haemorrhage laboratory terms (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1995-07-04
   Days after onset: 2
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: cirrhosis, liver; alpha-1 antitrypsin deficiency
Allergies:
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES95071678

Write-up: pt recv vax & on 02JUL95 pt hospitalized & died on 04JUL95 disseminated intravascular coagulation;


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