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This is VAERS ID 78670

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 78670
VAERS Form:
Age:1.3
Sex:Female
Location:New York
Vaccinated:1995-05-24
Onset:1995-06-06
Submitted:1995-10-31
Entered:1995-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: PEDVAXHIB / MSD 0640A / - - / -
MMR: MMR II / MSD 0552A / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: BRAIN SYND ACUTE, CONVULS, FEVER, APNEA, ENCEPHALOPATHY

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1995-06-10
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:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: p/receiving vax feverish & very pale-took pt for blood work 4 days prior to death-due to paleish face;went into a sx disorder & went into cardiac arrest was pronounced dead on arrival;


Changed on 12/8/2009

VAERS ID: 78670 Before After
VAERS Form:
Age:1.3
Sex:Female
Location:New York
Vaccinated:1995-05-24
Onset:1995-06-06
Submitted:1995-10-31
Entered:1995-11-09 1995-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: PEDVAXHIB HIB (PEDVAXHIB) / MSD MERCK & CO. INC. 0640A / - - / -
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 0552A / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Apnoea, Cardiac arrest, Convulsion, Delirium, Encephalopathy, Pallor, Pyrexia, BRAIN SYND ACUTE, CONVULS, FEVER, APNEA, ENCEPHALOPATHY

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1995-06-10
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:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: p/receiving vax feverish & very pale-took pt for blood work 4 days prior to death-due to paleish face;went into a sx disorder & went into cardiac arrest was pronounced dead on arrival;


Changed on 5/14/2017

VAERS ID: 78670 Before After
VAERS Form:
Age:1.3
Sex:Female
Location:New York
Vaccinated:1995-05-24
Onset:1995-06-06
Submitted:1995-10-31
Entered:1995-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0640A / - - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0552A / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Apnoea, Cardiac arrest, Convulsion, Delirium, Encephalopathy, Pallor, Pyrexia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1995-06-10
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:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: p/receiving vax feverish & very pale-took pt for blood work 4 days prior to death-due to paleish face;went into a sx disorder & went into cardiac arrest was pronounced dead on arrival;


Changed on 9/14/2017

VAERS ID: 78670 Before After
VAERS Form:(blank) 1
Age:1.3
Sex:Female
Location:New York
Vaccinated:1995-05-24
Onset:1995-06-06
Submitted:1995-10-31
Entered:1995-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0640A / - UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0552A / - UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Apnoea, Cardiac arrest, Convulsion, Delirium, Encephalopathy, Pallor, Pyrexia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1995-06-10
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:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: p/receiving vax feverish & very pale-took pt for blood work 4 days prior to death-due to paleish face;went into a sx disorder & went into cardiac arrest was pronounced dead on arrival;


Changed on 2/14/2018

VAERS ID: 78670 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:New York
Vaccinated:1995-05-24
Onset:1995-06-06
Submitted:1995-10-31
Entered:1995-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0640A / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0552A / UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Apnoea, Cardiac arrest, Convulsion, Delirium, Encephalopathy, Pallor, Pyrexia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1995-06-10
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:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: p/receiving vax feverish & very pale-took pt for blood work 4 days prior to death-due to paleish face;went into a sx disorder & went into cardiac arrest was pronounced dead on arrival;


Changed on 6/14/2018

VAERS ID: 78670 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:New York
Vaccinated:1995-05-24
Onset:1995-06-06
Submitted:1995-10-31
Entered:1995-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0640A / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0552A / UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Apnoea, Cardiac arrest, Convulsion, Delirium, Encephalopathy, Pallor, Pyrexia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1995-06-10
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:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: p/receiving vax feverish & very pale-took pt for blood work 4 days prior to death-due to paleish face;went into a sx disorder & went into cardiac arrest was pronounced dead on arrival;


Changed on 8/14/2018

VAERS ID: 78670 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:New York
Vaccinated:1995-05-24
Onset:1995-06-06
Submitted:1995-10-31
Entered:1995-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0640A / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0552A / UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Apnoea, Cardiac arrest, Convulsion, Delirium, Encephalopathy, Pallor, Pyrexia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1995-06-10
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:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: p/receiving vax feverish & very pale-took pt for blood work 4 days prior to death-due to paleish face;went into a sx disorder & went into cardiac arrest was pronounced dead on arrival;


Changed on 9/14/2018

VAERS ID: 78670 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:New York
Vaccinated:1995-05-24
Onset:1995-06-06
Submitted:1995-10-31
Entered:1995-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0640A / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0552A / UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Apnoea, Cardiac arrest, Convulsion, Delirium, Encephalopathy, Pallor, Pyrexia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1995-06-10
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:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: p/receiving vax feverish & very pale-took pt for blood work 4 days prior to death-due to paleish face;went into a sx disorder & went into cardiac arrest was pronounced dead on arrival;


Changed on 10/14/2018

VAERS ID: 78670 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:New York
Vaccinated:1995-05-24
Onset:1995-06-06
Submitted:1995-10-31
Entered:1995-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0640A / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0552A / UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Apnoea, Cardiac arrest, Convulsion, Delirium, Encephalopathy, Pallor, Pyrexia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1995-06-10
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:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: p/receiving vax feverish & very pale-took pt for blood work 4 days prior to death-due to paleish face;went into a sx disorder & went into cardiac arrest was pronounced dead on arrival;

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=78670&WAYBACKHISTORY=ON


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