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This is VAERS ID 93590

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 93590
VAERS Form:
Age:15.0
Sex:Female
Location:Foreign
Vaccinated:1995-02-23
Onset:1995-03-03
Submitted:1997-01-03
Entered:1997-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Hepatitis, Hepatocellular damage, Pyrexia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1996-09-04
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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES96121641

Write-up: 03mar95 pt became febrile & was tx by MD w/ amoxicillin. 19apr95 a 2nd course of amoxicillin was initiated. 23apr96 pt devel hepatitis & was hosp for observation.pt devel liver dysfunction & was transferred to another hosp; pt died


Changed on 5/14/2017

VAERS ID: 93590 Before After
VAERS Form:
Age:15.0
Sex:Female
Location:Foreign
Vaccinated:1995-02-23
Onset:1995-03-03
Submitted:1997-01-03
Entered:1997-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTIPV: DT + IPV (FOREIGN) / PASTEUR MERIEUX INST. - / - - / -
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Hepatitis, Hepatocellular damage, Pyrexia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1996-09-04
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES96121641

Write-up: 03mar95 pt became febrile & was tx by MD w/ amoxicillin. 19apr95 a 2nd course of amoxicillin was initiated. 23apr96 pt devel hepatitis & was hosp for observation.pt devel liver dysfunction & was transferred to another hosp; pt died


Changed on 9/14/2017

VAERS ID: 93590 Before After
VAERS Form:(blank) 1
Age:15.0
Sex:Female
Location:Foreign
Vaccinated:1995-02-23
Onset:1995-03-03
Submitted:1997-01-03
Entered:1997-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTIPV: DT + IPV (FOREIGN) / PASTEUR MERIEUX INST. - / - UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Hepatitis, Hepatocellular damage, Pyrexia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1996-09-04
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES96121641

Write-up: 03mar95 pt became febrile & was tx by MD w/ amoxicillin. 19apr95 a 2nd course of amoxicillin was initiated. 23apr96 pt devel hepatitis & was hosp for observation.pt devel liver dysfunction & was transferred to another hosp; pt died


Changed on 2/14/2018

VAERS ID: 93590 Before After
VAERS Form:1
Age:15.0
Sex:Female
Location:Foreign
Vaccinated:1995-02-23
Onset:1995-03-03
Submitted:1997-01-03
Entered:1997-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTIPV: DT + IPV (FOREIGN) / PASTEUR MERIEUX INST. - / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Hepatitis, Hepatocellular damage, Pyrexia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1996-09-04
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES96121641

Write-up: 03mar95 pt became febrile & was tx by MD w/ amoxicillin. 19apr95 a 2nd course of amoxicillin was initiated. 23apr96 pt devel hepatitis & was hosp for observation.pt devel liver dysfunction & was transferred to another hosp; pt died


Changed on 6/14/2018

VAERS ID: 93590 Before After
VAERS Form:1
Age:15.0
Sex:Female
Location:Foreign
Vaccinated:1995-02-23
Onset:1995-03-03
Submitted:1997-01-03
Entered:1997-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTIPV: DT + IPV (FOREIGN) / PASTEUR MERIEUX INST. - / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Hepatitis, Hepatocellular damage, Pyrexia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1996-09-04
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES96121641

Write-up: 03mar95 pt became febrile & was tx by MD w/ amoxicillin. 19apr95 a 2nd course of amoxicillin was initiated. 23apr96 pt devel hepatitis & was hosp for observation.pt devel liver dysfunction & was transferred to another hosp; pt died


Changed on 8/14/2018

VAERS ID: 93590 Before After
VAERS Form:1
Age:15.0
Sex:Female
Location:Foreign
Vaccinated:1995-02-23
Onset:1995-03-03
Submitted:1997-01-03
Entered:1997-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTIPV: DT + IPV (FOREIGN) / PASTEUR MERIEUX INST. - / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Hepatitis, Hepatocellular damage, Pyrexia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1996-09-04
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES96121641

Write-up: 03mar95 pt became febrile & was tx by MD w/ amoxicillin. 19apr95 a 2nd course of amoxicillin was initiated. 23apr96 pt devel hepatitis & was hosp for observation.pt devel liver dysfunction & was transferred to another hosp; pt died


Changed on 9/14/2018

VAERS ID: 93590 Before After
VAERS Form:1
Age:15.0
Sex:Female
Location:Foreign
Vaccinated:1995-02-23
Onset:1995-03-03
Submitted:1997-01-03
Entered:1997-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTIPV: DT + IPV (FOREIGN) / PASTEUR MERIEUX INST. - / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Hepatitis, Hepatocellular damage, Pyrexia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1996-09-04
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES96121641

Write-up: 03mar95 pt became febrile & was tx by MD w/ amoxicillin. 19apr95 a 2nd course of amoxicillin was initiated. 23apr96 pt devel hepatitis & was hosp for observation.pt devel liver dysfunction & was transferred to another hosp; pt died


Changed on 10/14/2018

VAERS ID: 93590 Before After
VAERS Form:1
Age:15.0
Sex:Female
Location:Foreign
Vaccinated:1995-02-23
Onset:1995-03-03
Submitted:1997-01-03
Entered:1997-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTIPV: DT + IPV (FOREIGN) / PASTEUR MERIEUX INST. - / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Hepatitis, Hepatocellular damage, Pyrexia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1996-09-04
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES96121641

Write-up: 03mar95 pt became febrile & was tx by MD w/ amoxicillin. 19apr95 a 2nd course of amoxicillin was initiated. 23apr96 pt devel hepatitis & was hosp for observation.pt devel liver dysfunction & was transferred to another hosp; pt died

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