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This is VAERS ID 96398

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 96398
VAERS Form:
Age:1.6
Sex:Male
Location:Tennessee
Vaccinated:1997-02-18
Onset:1997-02-26
Submitted:1997-02-27
Entered:1997-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPH: TETRAMUNE / LEDERLE 434814 / 3 RA / -
MMR: MMR II / MSD 0393D / 0 LA / -

Administered by: Public      Purchased by: Unknown
Symptoms: ASTHMA

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1997-02-26
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: unk
Preexisting Conditions: premie-7wk early followed @ hosp
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: death-asthma attack in MD office 26FEB97 & expired;had gone to hosp 25FEB97 to MD;


Changed on 12/8/2009

VAERS ID: 96398 Before After
VAERS Form:
Age:1.6
Sex:Male
Location:Tennessee
Vaccinated:1997-02-18
Onset:1997-02-26
Submitted:1997-02-27
Entered:1997-03-24 1997-03-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPH: TETRAMUNE / LEDERLE 434814 / 3 RA / -
DTPHIB: DTP + HIB (TETRAMUNE) / LEDERLE LABORATORIES 434814 / 3 RA / -
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 0393D / 0 LA / -

Administered by: Public      Purchased by: Unknown Public
Symptoms: Asthma, ASTHMA

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1997-02-26
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: unk
Preexisting Conditions: premie-7wk early followed @ hosp
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) TN97018

Write-up: death-asthma attack in MD office 26FEB97 & expired;had gone to hosp 25FEB97 to MD;


Changed on 5/14/2017

VAERS ID: 96398 Before After
VAERS Form:
Age:1.6
Sex:Male
Location:Tennessee
Vaccinated:1997-02-18
Onset:1997-02-26
Submitted:1997-02-27
Entered:1997-03-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPHIB: DTP + HIB (TETRAMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 434814 / 3 RA / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0393D / 0 LA / -

Administered by: Public      Purchased by: Public
Symptoms: Asthma

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1997-02-26
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: unk
Preexisting Conditions: premie-7wk early followed @ hosp
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': TN97018

Write-up: death-asthma attack in MD office 26FEB97 & expired;had gone to hosp 25FEB97 to MD;


Changed on 9/14/2017

VAERS ID: 96398 Before After
VAERS Form:(blank) 1
Age:1.6
Sex:Male
Location:Tennessee
Vaccinated:1997-02-18
Onset:1997-02-26
Submitted:1997-02-27
Entered:1997-03-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPHIB: DTP + HIB (TETRAMUNE) / PFIZER/WYETH 434814 / 3 4 RA / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0393D / 0 1 LA / -

Administered by: Public      Purchased by: Public
Symptoms: Asthma

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1997-02-26
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: unk
Preexisting Conditions: premie-7wk early followed @ hosp
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': TN97018

Write-up: death-asthma attack in MD office 26FEB97 & expired;had gone to hosp 25FEB97 to MD;


Changed on 2/14/2018

VAERS ID: 96398 Before After
VAERS Form:1
Age:1.6
Sex:Male
Location:Tennessee
Vaccinated:1997-02-18
Onset:1997-02-26
Submitted:1997-02-27
Entered:1997-03-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPHIB: DTP + HIB (TETRAMUNE) / PFIZER/WYETH 434814 / 4 RA / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0393D / 1 LA / -

Administered by: Public      Purchased by: Public
Symptoms: Asthma

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1997-02-26
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: unk
Preexisting Conditions: premie-7wk early followed @ hosp
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': TN97018

Write-up: death-asthma attack in MD office 26FEB97 & expired;had gone to hosp 25FEB97 to MD;


Changed on 6/14/2018

VAERS ID: 96398 Before After
VAERS Form:1
Age:1.6
Sex:Male
Location:Tennessee
Vaccinated:1997-02-18
Onset:1997-02-26
Submitted:1997-02-27
Entered:1997-03-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPHIB: DTP + HIB (TETRAMUNE) / PFIZER/WYETH 434814 / 4 RA / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0393D / 1 LA / -

Administered by: Public      Purchased by: Public
Symptoms: Asthma

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1997-02-26
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: unk
Preexisting Conditions: premie-7wk early followed @ hosp
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': TN97018

Write-up: death-asthma attack in MD office 26FEB97 & expired;had gone to hosp 25FEB97 to MD;


Changed on 8/14/2018

VAERS ID: 96398 Before After
VAERS Form:1
Age:1.6
Sex:Male
Location:Tennessee
Vaccinated:1997-02-18
Onset:1997-02-26
Submitted:1997-02-27
Entered:1997-03-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPHIB: DTP + HIB (TETRAMUNE) / PFIZER/WYETH 434814 / 4 RA / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0393D / 1 LA / -

Administered by: Public      Purchased by: Public
Symptoms: Asthma

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1997-02-26
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: unk
Preexisting Conditions: premie-7wk early followed @ hosp
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': TN97018

Write-up: death-asthma attack in MD office 26FEB97 & expired;had gone to hosp 25FEB97 to MD;


Changed on 9/14/2018

VAERS ID: 96398 Before After
VAERS Form:1
Age:1.6
Sex:Male
Location:Tennessee
Vaccinated:1997-02-18
Onset:1997-02-26
Submitted:1997-02-27
Entered:1997-03-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPHIB: DTP + HIB (TETRAMUNE) / PFIZER/WYETH 434814 / 4 RA / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0393D / 1 LA / -

Administered by: Public      Purchased by: Public
Symptoms: Asthma

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1997-02-26
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: unk
Preexisting Conditions: premie-7wk early followed @ hosp
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': TN97018

Write-up: death-asthma attack in MD office 26FEB97 & expired;had gone to hosp 25FEB97 to MD;


Changed on 10/14/2018

VAERS ID: 96398 Before After
VAERS Form:1
Age:1.6
Sex:Male
Location:Tennessee
Vaccinated:1997-02-18
Onset:1997-02-26
Submitted:1997-02-27
Entered:1997-03-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPHIB: DTP + HIB (TETRAMUNE) / PFIZER/WYETH 434814 / 4 RA / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0393D / 1 LA / -

Administered by: Public      Purchased by: Public
Symptoms: Asthma

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1997-02-26
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: unk
Preexisting Conditions: premie-7wk early followed @ hosp
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': TN97018

Write-up: death-asthma attack in MD office 26FEB97 & expired;had gone to hosp 25FEB97 to MD;

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=96398&WAYBACKHISTORY=ON


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