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This is VAERS ID 76787

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 76787
VAERS Form:
Age:1.6
Sex:Unknown
Location:Foreign
Vaccinated:1995-05-10
Onset:1995-06-29
Submitted:1995-08-18
Entered:1995-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Encephalitis, Infection, Meningism, Meningitis, Neoplasm, Strabismus, Vomiting

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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:
Allergies:
Diagnostic Lab Data: no relevant data
CDC 'Split Type': WAES95080780

Write-up: pt recv vax;on 29jun95 pt exp v;10 days later,pt devel strabismus & meningism;pt was hosp on 8jul95 & subsequently died;COD not provided;30JAN96-f/u indicates Coxsackie-B viral infect caused pt''s encephalitis,dx w/ medullablastoma of men


Changed on 5/14/2017

VAERS ID: 76787 Before After
VAERS Form:
Age:1.6
Sex:Unknown
Location:Foreign
Vaccinated:1995-05-10
Onset:1995-06-29
Submitted:1995-08-18
Entered:1995-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Encephalitis, Infection, Meningism, Meningitis, Neoplasm, Strabismus, Vomiting

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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:
Allergies:
Diagnostic Lab Data: no relevant data
CDC 'Split Type': WAES95080780

Write-up: pt recv vax;on 29jun95 pt exp v;10 days later,pt devel strabismus & meningism;pt was hosp on 8jul95 & subsequently died;COD not provided;30JAN96-f/u indicates Coxsackie-B viral infect caused pt''s encephalitis,dx w/ medullablastoma of men


Changed on 9/14/2017

VAERS ID: 76787 Before After
VAERS Form:(blank) 1
Age:1.6
Sex:Unknown
Location:Foreign
Vaccinated:1995-05-10
Onset:1995-06-29
Submitted:1995-08-18
Entered:1995-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / - UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Encephalitis, Infection, Meningism, Meningitis, Neoplasm, Strabismus, Vomiting

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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:
Allergies:
Diagnostic Lab Data: no relevant data
CDC 'Split Type': WAES95080780

Write-up: pt recv vax;on 29jun95 pt exp v;10 days later,pt devel strabismus & meningism;pt was hosp on 8jul95 & subsequently died;COD not provided;30JAN96-f/u indicates Coxsackie-B viral infect caused pt''s encephalitis,dx w/ medullablastoma of men


Changed on 2/14/2018

VAERS ID: 76787 Before After
VAERS Form:1
Age:1.6
Sex:Unknown
Location:Foreign
Vaccinated:1995-05-10
Onset:1995-06-29
Submitted:1995-08-18
Entered:1995-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Encephalitis, Infection, Meningism, Meningitis, Neoplasm, Strabismus, Vomiting

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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:
Allergies:
Diagnostic Lab Data: no relevant data
CDC 'Split Type': WAES95080780

Write-up: pt recv vax;on 29jun95 pt exp v;10 days later,pt devel strabismus & meningism;pt was hosp on 8jul95 & subsequently died;COD not provided;30JAN96-f/u indicates Coxsackie-B viral infect caused pt''s encephalitis,dx w/ medullablastoma of men


Changed on 6/14/2018

VAERS ID: 76787 Before After
VAERS Form:1
Age:1.6
Sex:Unknown
Location:Foreign
Vaccinated:1995-05-10
Onset:1995-06-29
Submitted:1995-08-18
Entered:1995-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Encephalitis, Infection, Meningism, Meningitis, Neoplasm, Strabismus, Vomiting

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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:
Allergies:
Diagnostic Lab Data: no relevant data
CDC 'Split Type': WAES95080780

Write-up: pt recv vax;on 29jun95 pt exp v;10 days later,pt devel strabismus & meningism;pt was hosp on 8jul95 & subsequently died;COD not provided;30JAN96-f/u indicates Coxsackie-B viral infect caused pt''s encephalitis,dx w/ medullablastoma of men


Changed on 8/14/2018

VAERS ID: 76787 Before After
VAERS Form:1
Age:1.6
Sex:Unknown
Location:Foreign
Vaccinated:1995-05-10
Onset:1995-06-29
Submitted:1995-08-18
Entered:1995-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Encephalitis, Infection, Meningism, Meningitis, Neoplasm, Strabismus, Vomiting

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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:
Allergies:
Diagnostic Lab Data: no relevant data
CDC 'Split Type': WAES95080780

Write-up: pt recv vax;on 29jun95 pt exp v;10 days later,pt devel strabismus & meningism;pt was hosp on 8jul95 & subsequently died;COD not provided;30JAN96-f/u indicates Coxsackie-B viral infect caused pt''s encephalitis,dx w/ medullablastoma of men


Changed on 9/14/2018

VAERS ID: 76787 Before After
VAERS Form:1
Age:1.6
Sex:Unknown
Location:Foreign
Vaccinated:1995-05-10
Onset:1995-06-29
Submitted:1995-08-18
Entered:1995-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Encephalitis, Infection, Meningism, Meningitis, Neoplasm, Strabismus, Vomiting

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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:
Allergies:
Diagnostic Lab Data: no relevant data
CDC 'Split Type': WAES95080780

Write-up: pt recv vax;on 29jun95 pt exp v;10 days later,pt devel strabismus & meningism;pt was hosp on 8jul95 & subsequently died;COD not provided;30JAN96-f/u indicates Coxsackie-B viral infect caused pt''s encephalitis,dx w/ medullablastoma of men


Changed on 10/14/2018

VAERS ID: 76787 Before After
VAERS Form:1
Age:1.6
Sex:Unknown
Location:Foreign
Vaccinated:1995-05-10
Onset:1995-06-29
Submitted:1995-08-18
Entered:1995-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Encephalitis, Infection, Meningism, Meningitis, Neoplasm, Strabismus, Vomiting

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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:
Allergies:
Diagnostic Lab Data: no relevant data
CDC 'Split Type': WAES95080780

Write-up: pt recv vax;on 29jun95 pt exp v;10 days later,pt devel strabismus & meningism;pt was hosp on 8jul95 & subsequently died;COD not provided;30JAN96-f/u indicates Coxsackie-B viral infect caused pt''s encephalitis,dx w/ medullablastoma of men

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=76787&WAYBACKHISTORY=ON


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