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This is VAERS ID 134334

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 134334
VAERS Form:
Age:
Sex:Unknown
Location:New Jersey
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2000-02-17
Entered:2000-02-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: ACT-HIB / CONNAUGHT LABS - / - - / IM
MEN: UNK. MENINGOCOCCAL POLYSACCHARIDE / UNCLASSIFIED - / - - / SC
PPV: PNEUMOVAX 23 / MSD - / - - / -

Administered by: Other      Purchased by: Unknown
Symptoms: CEREBROVASC ACCID

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: bone marrow transplant
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt recv''d Pneumovax,meningococcal, & ACTHIB vax. Subsequently, pt exp stroke-like symptoms. Pt sought unspecified medical attention.


Changed on 12/30/2006

VAERS ID: 134334 Before After
VAERS Form:
Age:
Sex:Unknown
Location:New Jersey
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2000-02-17
Entered:2000-02-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: ACT-HIB / CONNAUGHT LABS - / - - / IM
MEN: UNK. MENINGOCOCCAL POLYSACCHARIDE / UNCLASSIFIED - / - - / SC
PPV: PNEUMOVAX 23 / MSD - / - - / -

Administered by: Other      Purchased by: Unknown
Symptoms: CEREBROVASC ACCID

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: bone marrow transplant
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt recv''d recv''''d Pneumovax,meningococcal, & ACTHIB vax. Subsequently, pt exp stroke-like symptoms. Pt sought unspecified medical attention.


Changed on 12/8/2009

VAERS ID: 134334 Before After
VAERS Form:
Age:
Sex:Unknown
Location:New Jersey
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2000-02-17
Entered:2000-02-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: ACT-HIB HIB (ACTHIB) / CONNAUGHT LABS CONNAUGHT LABORATORIES - / - - / IM
MEN: UNK. MENINGOCOCCAL POLYSACCHARIDE MENINGOCOCCAL (NO BRAND NAME) / UNCLASSIFIED UNKNOWN MANUFACTURER - / - - / SC
PPV: PNEUMOVAX 23 PNEUMO (PNEUMOVAX) / MSD MERCK & CO. INC. - / - - / -

Administered by: Other Unknown      Purchased by: Unknown
Symptoms: Cerebrovascular accident, CEREBROVASC ACCID

Life Threatening? No
Birth Defect? No
Died? No Yes
   Date died:0000-00-00 2000-02-15
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: bone marrow transplant
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) WAES00020837

Write-up: Pt recv''''d recv''d Pneumovax,meningococcal, & ACTHIB vax. Subsequently, pt exp stroke-like symptoms. Pt sought unspecified medical attention. (OMIC)


Changed on 6/11/2011

VAERS ID: 134334 Before After
VAERS Form:
Age:
Sex:Unknown
Location:New Jersey
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2000-02-17
Entered:2000-02-24 2000-02-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (ACTHIB) / CONNAUGHT LABORATORIES - / - - / IM
MEN: MENINGOCOCCAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / SC
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cerebrovascular accident

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-02-15
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: bone marrow transplant
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES00020837

Write-up: Pt recv''d Pneumovax,meningococcal, & ACTHIB vax. Subsequently, pt exp stroke-like symptoms. Pt sought unspecified medical attention. (OMIC)


Changed on 9/14/2017

VAERS ID: 134334 Before After
VAERS Form:(blank) 1
Age:
Sex:Unknown
Location:New Jersey
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2000-02-17
Entered:2000-02-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (ACTHIB) / CONNAUGHT LABORATORIES - / - UNK - / IM
MEN: MENINGOCOCCAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK - / SC
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. - / - UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cerebrovascular accident

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-02-15
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: bone marrow transplant
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES00020837

Write-up: Pt recv''d Pneumovax,meningococcal, & ACTHIB vax. Subsequently, pt exp stroke-like symptoms. Pt sought unspecified medical attention. (OMIC)


Changed on 2/14/2018

VAERS ID: 134334 Before After
VAERS Form:1
Age:
Sex:Unknown
Location:New Jersey
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2000-02-17
Entered:2000-02-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (ACTHIB) / CONNAUGHT LABORATORIES - / UNK - / IM
MEN: MENINGOCOCCAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / SC
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cerebrovascular accident

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-02-15
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: bone marrow transplant
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES00020837

Write-up: Pt recv''d Pneumovax,meningococcal, & ACTHIB vax. Subsequently, pt exp stroke-like symptoms. Pt sought unspecified medical attention. (OMIC)


Changed on 6/14/2018

VAERS ID: 134334 Before After
VAERS Form:1
Age:
Sex:Unknown
Location:New Jersey
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2000-02-17
Entered:2000-02-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (ACTHIB) / CONNAUGHT LABORATORIES - / UNK - / IM
MEN: MENINGOCOCCAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / SC
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cerebrovascular accident

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-02-15
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: bone marrow transplant
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES00020837

Write-up: Pt recv''d Pneumovax,meningococcal, & ACTHIB vax. Subsequently, pt exp stroke-like symptoms. Pt sought unspecified medical attention. (OMIC)


Changed on 8/14/2018

VAERS ID: 134334 Before After
VAERS Form:1
Age:
Sex:Unknown
Location:New Jersey
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2000-02-17
Entered:2000-02-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (ACTHIB) / CONNAUGHT LABORATORIES - / UNK - / IM
MEN: MENINGOCOCCAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / SC
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cerebrovascular accident

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-02-15
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: bone marrow transplant
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES00020837

Write-up: Pt recv''d Pneumovax,meningococcal, & ACTHIB vax. Subsequently, pt exp stroke-like symptoms. Pt sought unspecified medical attention. (OMIC)


Changed on 9/14/2018

VAERS ID: 134334 Before After
VAERS Form:1
Age:
Sex:Unknown
Location:New Jersey
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2000-02-17
Entered:2000-02-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (ACTHIB) / CONNAUGHT LABORATORIES - / UNK - / IM
MEN: MENINGOCOCCAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / SC
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cerebrovascular accident

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-02-15
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: bone marrow transplant
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES00020837

Write-up: Pt recv''d Pneumovax,meningococcal, & ACTHIB vax. Subsequently, pt exp stroke-like symptoms. Pt sought unspecified medical attention. (OMIC)


Changed on 10/14/2018

VAERS ID: 134334 Before After
VAERS Form:1
Age:
Sex:Unknown
Location:New Jersey
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2000-02-17
Entered:2000-02-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (ACTHIB) / CONNAUGHT LABORATORIES - / UNK - / IM
MEN: MENINGOCOCCAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / SC
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cerebrovascular accident

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-02-15
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: bone marrow transplant
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES00020837

Write-up: Pt recv''d Pneumovax,meningococcal, & ACTHIB vax. Subsequently, pt exp stroke-like symptoms. Pt sought unspecified medical attention. (OMIC)

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=134334&WAYBACKHISTORY=ON


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