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This is VAERS ID 184346

(NOTE: This result is from the 12/31/2003 version of the VAERS database)

Case Details

VAERS ID: 184346 (history)  
Form: Version .0  
Age: 1.1  
Sex: Female  
Location: California  
Vaccinated:2002-04-04
Onset:2002-04-27
   Days after vaccination:23
Submitted: 2002-05-01
   Days after onset:4
Entered: 2002-05-09
   Days after submission:8
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1379L / 0 RL / SC
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0573L / 0 LL / SC

Administered by: Private       Purchased by: Unknown
Symptoms: HEART ARREST, INFECT, REACT UNEVAL, SHOCK
SMQs:

Life Threatening? Yes
Birth Defect? No
Died? No
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: RSV Bronchiolitis and pneumonia
Preexisting Conditions: Congenital ichthyosis, failure to thrive,
Allergies:
Diagnostic Lab Data: VZV-DFA (+)
CDC Split Type:

Write-up: Disseminated VZV with multi-organ failure, shock, CV arrest. Diagnosed with Superficial cellulitis, Otitis externa, hepatomegaly


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=184346


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