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This is VAERS ID 76575

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 76575
VAERS Form:
Age:1.0
Sex:Male
Location:Foreign
Vaccinated:1995-06-27
Onset:1995-07-02
Submitted:1995-08-02
Entered:1995-08-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Coagulopathy, Hepatic cirrhosis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1995-07-04
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
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;


Changed on 5/14/2017

VAERS ID: 76575 Before After
VAERS Form:
Age:1.0
Sex:Male
Location:Foreign
Vaccinated:1995-06-27
Onset:1995-07-02
Submitted:1995-08-02
Entered:1995-08-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Coagulopathy, Hepatic cirrhosis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1995-07-04
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? 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;


Changed on 9/14/2017

VAERS ID: 76575 Before After
VAERS Form:(blank) 1
Age:1.0
Sex:Male
Location:Foreign
Vaccinated:1995-06-27
Onset:1995-07-02
Submitted:1995-08-02
Entered:1995-08-08
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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1995-07-04
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? 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;


Changed on 2/14/2018

VAERS ID: 76575 Before After
VAERS Form:1
Age:1.0
Sex:Male
Location:Foreign
Vaccinated:1995-06-27
Onset:1995-07-02
Submitted:1995-08-02
Entered:1995-08-08
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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1995-07-04
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? 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;


Changed on 6/14/2018

VAERS ID: 76575 Before After
VAERS Form:1
Age:1.0
Sex:Male
Location:Foreign
Vaccinated:1995-06-27
Onset:1995-07-02
Submitted:1995-08-02
Entered:1995-08-08
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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1995-07-04
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? 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;


Changed on 8/14/2018

VAERS ID: 76575 Before After
VAERS Form:1
Age:1.0
Sex:Male
Location:Foreign
Vaccinated:1995-06-27
Onset:1995-07-02
Submitted:1995-08-02
Entered:1995-08-08
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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1995-07-04
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? 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;


Changed on 9/14/2018

VAERS ID: 76575 Before After
VAERS Form:1
Age:1.0
Sex:Male
Location:Foreign
Vaccinated:1995-06-27
Onset:1995-07-02
Submitted:1995-08-02
Entered:1995-08-08
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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1995-07-04
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? 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;


Changed on 10/14/2018

VAERS ID: 76575 Before After
VAERS Form:1
Age:1.0
Sex:Male
Location:Foreign
Vaccinated:1995-06-27
Onset:1995-07-02
Submitted:1995-08-02
Entered:1995-08-08
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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1995-07-04
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? 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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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=76575&WAYBACKHISTORY=ON


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