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This is VAERS ID 239690

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 239690
VAERS Form:
Age:1.0
Sex:Male
Location:Nebraska
Vaccinated:2005-06-03
Onset:2005-06-09
Submitted:2005-06-10
Entered:2005-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0346P / 0 LL / SC
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0989 / 0 RL / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: CYANOSIS, APNEA, CARDIOVASC DIS

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2005-06-09
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: 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.


Changed on 12/8/2009

VAERS ID: 239690 Before After
VAERS Form:
Age:1.0
Sex:Male
Location:Nebraska
Vaccinated:2005-06-03
Onset:2005-06-09
Submitted:2005-06-10
Entered:2005-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0346P / 0 LL / SC
VARCEL: VARICELLA (VARIVAX) VARICELLA (VARIVAX) / MERCK & CO. INC. 0989 / 0 RL / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Cyanosis, Pulse absent, CYANOSIS, APNEA, CARDIOVASC DIS

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2005-06-09
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: 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.


Changed on 9/14/2017

VAERS ID: 239690 Before After
VAERS Form:(blank) 1
Age:1.0
Sex:Male
Location:Nebraska
Vaccinated:2005-06-03
Onset:2005-06-09
Submitted:2005-06-10
Entered:2005-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0346P / 0 1 LL / SC
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0989 / 0 1 RL / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Cyanosis, Pulse absent

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2005-06-09
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: 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.


Changed on 2/14/2018

VAERS ID: 239690 Before After
VAERS Form:1
Age:1.0
Sex:Male
Location:Nebraska
Vaccinated:2005-06-03
Onset:2005-06-09
Submitted:2005-06-10
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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2005-06-09
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: 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.


Changed on 6/14/2018

VAERS ID: 239690 Before After
VAERS Form:1
Age:1.0
Sex:Male
Location:Nebraska
Vaccinated:2005-06-03
Onset:2005-06-09
Submitted:2005-06-10
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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2005-06-09
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: 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.


Changed on 8/14/2018

VAERS ID: 239690 Before After
VAERS Form:1
Age:1.0
Sex:Male
Location:Nebraska
Vaccinated:2005-06-03
Onset:2005-06-09
Submitted:2005-06-10
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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2005-06-09
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: 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.


Changed on 9/14/2018

VAERS ID: 239690 Before After
VAERS Form:1
Age:1.0
Sex:Male
Location:Nebraska
Vaccinated:2005-06-03
Onset:2005-06-09
Submitted:2005-06-10
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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2005-06-09
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: 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.


Changed on 10/14/2018

VAERS ID: 239690 Before After
VAERS Form:1
Age:1.0
Sex:Male
Location:Nebraska
Vaccinated:2005-06-03
Onset:2005-06-09
Submitted:2005-06-10
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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2005-06-09
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: 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.

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=239690&WAYBACKHISTORY=ON


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