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From the 6/11/2021 release of VAERS data:

Found 385 cases where Vaccine is MMR and Patient Died and Vaccination Date on/before '2015-01-31'



Case Details

This is page 14 out of 39

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VAERS ID: 219786 (history)  
Form: Version 1.0  
Age: 1.2  
Sex: Male  
Location: Idaho  
Vaccinated:2004-04-30
Onset:2004-05-01
   Days after vaccination:1
Submitted: 2004-05-01
   Days after onset:0
Entered: 2004-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS 630B2 / 4 RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0678N / 1 RL / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1350N / 1 LL / IM

Administered by: Private       Purchased by: Public
Symptoms: Apnoea, Cardiac arrest, Coma, Cyanosis, Dyspnoea, Irritability, Mydriasis, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Respiratory failure (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2004-05-01
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: aspirin 1/4 tab daily
Current Illness: tx for sinusitis on 4/21 with Amoxicillin, was seen 4/30, in normal state of health
Preexisting Conditions: Tetrology of Fallot with severe PS, VSD & Hypertrophied R ventricle, Double Outlet R, vent, Imperforate anus, VATER syndrome, s/p colostomy,
Allergies:
Diagnostic Lab Data: Unknown from hospital where pt coded.
CDC Split Type:

Write-up: After vaccination, pt irritable and emesis 1-2 x. No fever. Acting better by morning. Mom gave pt bottle at ~4:30 am. Pt developed respiratory difficulty at ~5-5:30 am. Dad initiated CPR and ambulance called. Pt received CPR to local hospital. Coded there for 30-45 min (not at my facility). Pronounced dead at ~6:30 am. Nurse follow up on 05/14/04 states: Unresponsive, cyanosis, pupils fixed, apneic, asystold (stupor, cyanosis, mydriasis, apnea, heart arrest).


VAERS ID: 222269 (history)  
Form: Version 1.0  
Age: 1.05  
Sex: Male  
Location: Unknown  
Vaccinated:2004-03-31
Onset:2004-04-26
   Days after vaccination:26
Submitted: 2004-08-10
   Days after onset:106
Entered: 2004-06-03
   Days after submission:68
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS 21924A2 / UNK RL / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 6467050823N / 1 LL / -
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 6477101248N / 1 LL / -

Administered by: Other       Purchased by: Other
Symptoms: Anaemia, Anorexia, Cardiac failure, Drug ineffective, Haematemesis, Immune system disorder, Pneumonitis, Rash papular, Respiratory distress, Skin ulcer, Somnolence, Vomiting
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Haematopoietic erythropenia (broad), Lack of efficacy/effect (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Interstitial lung disease (narrow), Anticholinergic syndrome (broad), Dementia (broad), Gastrointestinal haemorrhage (narrow), Acute central respiratory depression (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (narrow), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: DiGeorge''s Syndrome
Preexisting Conditions: Medical history: Surgery; Fallot''s tetralogy; Ventricular septal defect repair. Concurrent condition: DiGeorge''s syndrome.
Allergies:
Diagnostic Lab Data: Chest x-ray: diffuse pulmonary opacities; Tracheal aspirate positive for measles virus; 2 urines were PCR positive for measles; Blood CD4 count 320; VZV pending - lesion type papule, VZV positive, vaccine type, bronchial washings
CDC Split Type: WAES0405USA01493

Write-up: Information has been received from a physician via the VZV identification program concerning a 13 month old male with DiGeorge''s syndrome status post central shunt (March 2003) and Rastelli repair for tetralogy of Fallot (26-Jan-2004) who on 31-Mar-2004 was vaccinated with a first dose of measles virus vaccine live (+) mumps virus vaccine live (+) rubella virus vaccine live (lot number 646705/0823N) and a first dose of varicella virus vaccine live (lot number 637710/1248N) in the left leg. The patient was concomitantly vaccinated on 31-Mar-2004 with a dose of diphtheria toxoid (+) hepatitis B virus vaccine rHBsAg (yeast) (+) pertussis acellular 3-component vaccine (+) poliovirus vaccine inactivated (+) tetanus toxoid) (lot 21924A2) in the right leg. It was reported that the patient did not developed a rash at the injection site post vaccination. On approximately 26-Apr-2004, the patient developed diffuse bilateral pneumonitis possibly due to heart failure. The patient was afebrile. On 03-May-2004, the patient was admitted to the hospital with severe amenia, congestive heart failure, and bloody emesis. Patient had decreased po intake lethargy, and retching for 1 week prior to admission. On 13-May-2004, the patient''s pneumonitis worsened. The patient developed an increased requirement for pressor support, worsening respiratory distress requiring intubation and had diffuse pulmonary opacities on CXR. Therapy with caspofungin was stated on 13-May-2004. On 20-May-2004, therapy with ribavirin, vancomycin, and piperacillin was started. On 21-May-2004, the patient developed a papular rash with 5 lesions scattered on the trunk. On 21-May-2004, therapy with acyclovir was started. A culture/PCR from tracheal aspirate for varicella and measles was performed on 19-May-2004 and 21-May-2004, and a papule specimen was taken 21-May-2004. Preliminary reports from the CDC revealed that the culture from tracheal aspirate taken 21-May-2004 and 2 urines were PCR positive for measles virus (Strain ID to follow). The PCRs were being repeated to verify the result. The physician reported that the patient had originally been seen by an infectious disease physician and placed on sufamethoxazole/trimethropim (Bactim) for a low CD4 count (320). The infectious disease (ID) physician advised that the patient should not be vaccinated with any live vaccines. It was reported that the patient did not have any recent exposure to shingles and exposure to chicken pox was unknown. Vaccination history included on 11-Jun-2003, the patient was vaccinated with a dose of diptheria toxoid (+) hepatitis B virus vaccine rHBsAg (yeast) (+) pertussis acellular 3-component vaccine (+) poliovirus vaccine inactivated (+) tetanus toxoid) (lot 21882C2) in the right leg, Hib conj vaccine (OMPC) (PedvaxHIB) (lot 1307L) in the left leg, and pneumococcal 4 6B 9V 14 18C 19F 23F conj vaccine (CRM197) (lot 491589) in the left leg. Additional information has been requested. Follow up on 06/08/04 states: "Follow up information indicated that the vesicle and bronchial washings samples obtained on 05/17/04 were VZV positive and the VZV strain that was identified was vaccine-type. Follow up information was received from the physician who reported that the child''s pulmonary disease was not secondary to the vaccinations he received. The physician indicated that he could not share additional findings at this time. Follow up information indicated that the patient died. PCR testing from autopsy samples on the lungs and lymph node were negative or VZV. Additional information has been requested."


VAERS ID: 224262 (history)  
Form: Version 1.0  
Age: 4.0  
Sex: Male  
Location: Montana  
Vaccinated:2004-06-10
Onset:2004-07-06
   Days after vaccination:26
Submitted: 2004-07-22
   Days after onset:16
Entered: 2004-07-23
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C1527AA / 5 RA / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR X0707 / 4 RA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0610N / 2 LA / SC

Administered by: Public       Purchased by: Public
Symptoms: Apnoea, Brain oedema, Convulsion, Eye irritation, Eye swelling, Lymphadenopathy, Pyrexia, Viral infection
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Acute central respiratory depression (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hyponatraemia/SIADH (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Corneal disorders (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (narrow), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2004-07-09
   Days after onset: 3
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Sachronic meds
Current Illness: NONE
Preexisting Conditions: No chronic disease.
Allergies:
Diagnostic Lab Data: Serum/CSF/Autopsy specimens pending.
CDC Split Type:

Write-up: 7/4/04: Puffy eyes/itchy eyes, diagnosed with OM. Prescribed but did not take amoxicillin (because of possible allergy). 7/6/04: Clinic. Temp 102.7. B posterior lymphadenopathy; alert, well appearing. 7/7/04 Seizure at home. ED; repeat seizure, apneic episodes 3 times. Flumazanil, Dilantin and transferred. Never regained consciousness. LP positive, WBC. Died 7/9/04. Labs. Nurse follow up on 08/02/04 states: "Complete." Autopsy report received stated patient experienced Epstein Barr infection and cerebral edema.


VAERS ID: 230877 (history)  
Form: Version 1.0  
Age: 1.13  
Sex: Female  
Location: Arkansas  
Vaccinated:2004-04-22
Onset:2004-04-24
   Days after vaccination:2
Submitted: 2004-05-17
   Days after onset:23
Entered: 2004-12-13
   Days after submission:210
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / SANOFI PASTEUR U172AA / 3 RA / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UE094AA / 3 LA / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR X0313 / 3 RA / SC
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0958N / 1 LA / SC
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0885N / 1 RA / SC

Administered by: Public       Purchased by: Public
Symptoms: Abnormal sleep-related event, Apnoea, Pharyngitis, Rhinitis, Rhinorrhoea, Sudden infant death syndrome
SMQs:, Agranulocytosis (broad), Oropharyngeal infections (narrow), Acute central respiratory depression (narrow), Neonatal disorders (narrow), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2004-04-24
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: mini case of chicken pox~Varicella (no brand name)~1~1.00~In Sibling|~Varicella (no brand name)~~0.00~In Sibling
Other Medications: Tylenol Elixir with Hydrocodone
Current Illness: NONE
Preexisting Conditions: Ear infection 1 month prior to immunizations.
Allergies:
Diagnostic Lab Data: Autopsy results pending.
CDC Split Type: AR0464

Write-up: Infant seemed fine except for cold (clear drainage) and was teething (2 teeth trying to come in). 4/23/04 PM, infant became more upset. Mother gave infant Tylenol Elixir with hydrocodone and infant spit it out on clothes. Infant was alive at 2 AM on 4/24/04 and was not breathing at 8 AM. Mother took her to ER. Autopsy report received which revealed COD to be SIDS & cosleeping.


VAERS ID: 233373 (history)  
Form: Version 1.0  
Age: 1.01  
Sex: Male  
Location: Georgia  
Vaccinated:2005-02-01
Onset:2005-02-03
   Days after vaccination:2
Submitted: 2005-02-03
   Days after onset:0
Entered: 2005-02-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR 41580AA / 2 RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0608P / 1 RA / SC
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0765P / 1 LA / SC

Administered by: Unknown       Purchased by: Unknown
Symptoms: Apnoea, Hypothermia, Sudden infant death syndrome
SMQs:, Acute central respiratory depression (narrow), Accidents and injuries (broad), Neonatal disorders (narrow), Respiratory failure (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2005-02-03
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: Upper respiratory infection
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Autopsy is pending
CDC Split Type:

Write-up: Patient was found this afternoon cold and not breathing. His resuscitation was not successful. Autopsy report received stated COD was SIDS.


VAERS ID: 239566 (history)  
Form: Version 1.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2005-06-06
Entered: 2005-06-10
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -

Administered by: Other       Purchased by: Other
Symptoms: Unevaluable event
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC Split Type: WAES0506USA00124

Write-up: Information has been received from a consumer concerning her son who was vaccinated with measles virus vaccine live (Enders-Edmonston) (+) mumps virus vaccine live (Jeryl Lynn) (+) rubella virus vaccine live (Wistar RA 27/3). Subsequently, her son passed away. Medical attention was sought. No product quality complaint involved. No further information is available.


VAERS ID: 239690 (history)  
Form: Version 1.0  
Age: 1.0  
Sex: Male  
Location: Nebraska  
Vaccinated:2005-06-03
Onset:2005-06-09
   Days after vaccination:6
Submitted: 2005-06-10
   Days after onset:1
Entered: 2005-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0346P / 1 LL / SC
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0989 / 1 RL / SC

Administered by: Unknown       Purchased by: Unknown
Symptoms: Apnoea, Cyanosis, Pulse absent
SMQs:, Anaphylactic reaction (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (narrow), Hypotonic-hyporesponsive episode (broad), Respiratory failure (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2005-06-09
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 1)cetirizine 2.5 mg po q 24 hrs 2)fluticasone 44mcg oral inhalation aerosol, 2-3 puffs via Aerochamber mask q 12 hrs 3)ipratropium via nebulizer q 6 hrs or less frequently
Current Illness: No acute illness. Reactive airway disease under good control. Mild anemia diagnosed 6/3/2005.
Preexisting Conditions: Reactive airway disease, under good control at time of immunization. Recent PET placement for recurrent otitis. cow''s milk allergy; no anaphyllaxis.
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: On the morning of 6/9/2005, patient was found in his crib apneic and without pulse. Resuscitation attempts were unsuccessful and the child was pronounced dead in the Emergency Room. Additional co start from Discharge summary rec''d 06/13/2005 -- cyanosis.


VAERS ID: 239904 (history)  
Form: Version 1.0  
Age: 2.0  
Sex: Male  
Location: Ohio  
Vaccinated:2005-05-20
Onset:2005-05-28
   Days after vaccination:8
Submitted: 2005-06-13
   Days after onset:16
Entered: 2005-06-16
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0608P / UNK - / -
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0652P / UNK - / -

Administered by: Private       Purchased by: Private
Symptoms: Cardio-respiratory arrest, Cardiomyopathy, Pneumonia, Premature baby, Pyrexia
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (broad), Cardiomyopathy (narrow), Eosinophilic pneumonia (broad), Neonatal disorders (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2005-05-29
   Days after onset: 1
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Albnuterol, Flovent, Zantac, Laser, KCL, O2
Current Illness: Trach feeding tube, BDP
Preexisting Conditions: Immune system disorder; prematurity; hospitalization
Allergies:
Diagnostic Lab Data: Body temp high temperatures
CDC Split Type: WAES0506USA00683

Write-up: Information has been received from a RN concerning a 21 month old immunocompromised male who was vaccinated with a dose of varicella virus vaccine live. Concomitant vaccination included a dose of measles virus vaccine live (Enders-Edmonston) (+) mumps virus vaccine live (Jeryl Lynn) (+) rubella virus vaccine live (Wistar RA 27/3). Subsequently the pt was hospitalized and died two weeks later (not further specified). A product quality complaint was not involved. Additional information was received from the RN who reported that the pt had a lot of problems. The pt was hospitalized until he was 20 months old with a diagnosis of extreme prematurity among other problems. The nurse did not know the cause of death but did indicate that high temperatures were involved. Additional information was received from a health professional at a pediatricians office who reported that the pt''s demise had nothing to do with the vaccinations. The pt''s experience was considered to be immediately life threatening and disabling by the RN. Additional information has been requested. Received Autopsy Report which revealed COD as acute bronchopneumonia, bronchopulmonary dysplasia, dilated cardiomyopathy & prematurity.


VAERS ID: 239968 (history)  
Form: Version 1.0  
Age: 1.04  
Sex: Female  
Location: Ohio  
Vaccinated:2004-10-19
Onset:2004-10-21
   Days after vaccination:2
Submitted: 2004-11-09
   Days after onset:19
Entered: 2005-06-16
   Days after submission:218
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UE118AA / 4 RL / IM
MMR: MEASLES + MUMPS + RUBELLA (VIRIVAC) / MERCK & CO. INC. 0821N / 1 LA / SC
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH A74399K / 3 LL / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Blood glucose increased, Bradycardia, Brain oedema, Cough, Dehydration, Hyponatraemia, Hypoventilation, Irritability, Ketoacidosis, Lethargy, Pain, Pallor, Pneumonia, Polyuria, Pyrexia, Tachycardia, Weight decreased
SMQs:, Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hyponatraemia/SIADH (narrow), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Chronic kidney disease (broad), Tubulointerstitial diseases (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (narrow), Dehydration (narrow), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: Slight Cough - T99.8 - Lungs clear
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Blood sugars, Blood tests, X-rays
CDC Split Type:

Write-up: Had been to MD week of 10/18 with normal well child exam. 10/19/2004 slight cough, chest clear temp 99.8 in our office. To MD office 10/21/04 - Dx beginning pneumonia. Antibiotic inj. given and sent home. 10/22/04 Rapid progression of pneumonia at ER. Blood sugar 700+ Dx: Diabetic Ketoacidosis. Life flight to Hosp. Brain stem swelling. Pt died 10/24. Added code of dehydration from Death Certificate rec''d 06/13/2005. From discharge Summary rec''d 06/21/2005, added terms are polyuris, lethargy, weight loss, tachycardia, dehydration, irritable, bradycardia, hypoventilation, pain, hyperventilation, pallow, and hyponatremia.


VAERS ID: 243201 (history)  
Form: Version 1.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2005-08-18
Entered: 2005-08-22
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. UNK / UNK UN / -

Administered by: Other       Purchased by: Other
Symptoms: Unevaluable event
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC Split Type: WAES0508USA02266

Write-up: Information has been received from a consumer concerning at least three people (ages and gender not reported) who died after being vaccinated (dates not specified) with MMR II (lot numbers not reported). No further information is available. there was no product quality complaint involved.


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