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This is VAERS ID 90259

Case Details

VAERS ID: 90259 (history)  
Form: Version 1.0  
Age: 1.0  
Sex: Male  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 1996-09-24
Entered: 1996-09-27
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 1 - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Injury
SMQs:, Accidents and injuries (narrow), Hostility/aggression (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1996-07-19
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness:
Preexisting Conditions: no relevant history
Allergies:
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES96091432

Write-up: pt recv vax & died suddenly 9 days following vax;COD unk;no further details were provided;


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