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History of Changes from the VAERS Wayback Machine |
VAERS ID: | 249598 |
VAERS Form: | |
Age: | |
Sex: | Unknown |
Location: | Unknown |
Vaccinated: | 0000-00-00 |
Onset: | 0000-00-00 |
Submitted: | 2005-12-16 |
Entered: | 2005-12-21 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. | - / 1 | UN / - |
Administered by: Other Purchased by: Unknown
Symptoms: REACT UNEVAL
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:0000-00-00
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: UNK
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':
Write-up: Information has been received from a consumer concerning a patient who was vaccinated with the second dose of measles virus vaccine live (+) mumps virus vaccine live (+) rubella virus vaccine live. The consumer reported that she /"heard of a patient who d"ied after the second MMR shot./" No further information is available.
Vaccinated: | 0000-00-00 |
Onset: | 0000-00-00 |
Submitted: | 2005-12-16 |
Entered: | 2005-12-21 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. | - / 1 | UN / - |
Administered by: Other Purchased by: Unknown Other
Symptoms: Unevaluable event, REACT UNEVAL
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:0000-00-00
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: UNK
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) WAES0512USA01522
Write-up: Information has been received from a consumer concerning a patient who was vaccinated with the second dose of measles virus vaccine live (+) mumps virus vaccine live (+) rubella virus vaccine live. The consumer reported that she /"heard "heard of a patient who d"ied died after the second MMR shot./" shot." No further information is available.
Vaccinated: | 0000-00-00 |
Onset: | 0000-00-00 |
Submitted: | 2005-12-16 |
Entered: | 2005-12-21 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. | - / 1 2 | UN / - |
Administered by: Other Purchased by: Other
Symptoms: Unevaluable event
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:0000-00-00
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: UNK
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0512USA01522
Write-up: Information has been received from a consumer concerning a patient who was vaccinated with the second dose of measles virus vaccine live (+) mumps virus vaccine live (+) rubella virus vaccine live. The consumer reported that she "heard of a patient who died after the second MMR shot." No further information is available.
Vaccinated: | 0000-00-00 |
Onset: | 0000-00-00 |
Submitted: | 2005-12-16 |
Entered: | 2005-12-21 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. | - / 2 | UN / - |
Administered by: Other Purchased by: Other
Symptoms: Unevaluable event
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:0000-00-00
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: UNK
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0512USA01522
Write-up: Information has been received from a consumer concerning a patient who was vaccinated with the second dose of measles virus vaccine live (+) mumps virus vaccine live (+) rubella virus vaccine live. The consumer reported that she "heard of a patient who died after the second MMR shot." No further information is available.
Vaccinated: | 0000-00-00 |
Onset: | 0000-00-00 |
Submitted: | 2005-12-16 |
Entered: | 2005-12-21 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. | - / 2 | UN / - |
Administered by: Other Purchased by: Other
Symptoms: Unevaluable event
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:0000-00-00
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: UNK
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0512USA01522
Write-up: Information has been received from a consumer concerning a patient who was vaccinated with the second dose of measles virus vaccine live (+) mumps virus vaccine live (+) rubella virus vaccine live. The consumer reported that she "heard of a patient who died after the second MMR shot." No further information is available.
Vaccinated: | 0000-00-00 |
Onset: | 0000-00-00 |
Submitted: | 2005-12-16 |
Entered: | 2005-12-21 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. | - / 2 | UN / - |
Administered by: Other Purchased by: Other
Symptoms: Unevaluable event
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:0000-00-00
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: UNK
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0512USA01522
Write-up: Information has been received from a consumer concerning a patient who was vaccinated with the second dose of measles virus vaccine live (+) mumps virus vaccine live (+) rubella virus vaccine live. The consumer reported that she "heard of a patient who died after the second MMR shot." No further information is available.
Vaccinated: | 0000-00-00 |
Onset: | 0000-00-00 |
Submitted: | 2005-12-16 |
Entered: | 2005-12-21 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. | - / 2 | UN / - |
Administered by: Other Purchased by: Other
Symptoms: Unevaluable event
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:0000-00-00
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: UNK
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0512USA01522
Write-up: Information has been received from a consumer concerning a patient who was vaccinated with the second dose of measles virus vaccine live (+) mumps virus vaccine live (+) rubella virus vaccine live. The consumer reported that she "heard of a patient who died after the second MMR shot." No further information is available.
Vaccinated: | 0000-00-00 |
Onset: | 0000-00-00 |
Submitted: | 2005-12-16 |
Entered: | 2005-12-21 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. | - / 2 | UN / - |
Administered by: Other Purchased by: Other
Symptoms: Unevaluable event
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:0000-00-00
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: UNK
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0512USA01522
Write-up: Information has been received from a consumer concerning a patient who was vaccinated with the second dose of measles virus vaccine live (+) mumps virus vaccine live (+) rubella virus vaccine live. The consumer reported that she "heard of a patient who died after the second MMR shot." No further information is available.
Link To This Search Result:
https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=249598&WAYBACKHISTORY=ON
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