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This is VAERS ID 233373

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

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

Administered by: Unknown      Purchased by: Unknown
Symptoms: APNEA, HYPOTHERMIA

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2005-02-03
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: 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.


Changed on 12/8/2009

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

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Hypothermia, Sudden infant death syndrome, APNEA, HYPOTHERMIA

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2005-02-03
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: 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.


Changed on 7/7/2013

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

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Hypothermia, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2005-02-03
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: 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.


Changed on 2/14/2017

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

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Hypothermia, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2005-02-03
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: 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.


Changed on 9/14/2017

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

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Hypothermia, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2005-02-03
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: 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.


Changed on 2/14/2018

VAERS ID: 233373 Before After
VAERS Form:1
Age:1.01
Sex:Male
Location:Georgia
Vaccinated:2005-02-01
Onset:2005-02-03
Submitted:2005-02-03
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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2005-02-03
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: 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.


Changed on 6/14/2018

VAERS ID: 233373 Before After
VAERS Form:1
Age:1.01
Sex:Male
Location:Georgia
Vaccinated:2005-02-01
Onset:2005-02-03
Submitted:2005-02-03
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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2005-02-03
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: 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.


Changed on 8/14/2018

VAERS ID: 233373 Before After
VAERS Form:1
Age:1.01
Sex:Male
Location:Georgia
Vaccinated:2005-02-01
Onset:2005-02-03
Submitted:2005-02-03
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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2005-02-03
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: 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.


Changed on 9/14/2018

VAERS ID: 233373 Before After
VAERS Form:1
Age:1.01
Sex:Male
Location:Georgia
Vaccinated:2005-02-01
Onset:2005-02-03
Submitted:2005-02-03
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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2005-02-03
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: 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.


Changed on 10/14/2018

VAERS ID: 233373 Before After
VAERS Form:1
Age:1.01
Sex:Male
Location:Georgia
Vaccinated:2005-02-01
Onset:2005-02-03
Submitted:2005-02-03
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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2005-02-03
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: 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.

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