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This is VAERS ID 25556

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 25556
VAERS Form:
Age:
Sex:Female
Location:New York
Vaccinated:1989-10-20
Onset:1989-10-25
Submitted:0000-00-00
Entered:1990-07-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: UNK. DTP / UNCLASSIFIED - / - - / -
MMR: MMR II / MSD 42622/1644R / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: SEPSIS

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1989-10-25
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:
Current Illness: no relevant history
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: autopsy-strep sepsis, The physician & autopsy pathologist felt that the pt''s dealth was not related to vaccination.
CDC 'Split Type':

Write-up: MD reported pt initially vac. w/ MMR live at 15 mo''s was vac. w/ booster MMR on 10-20-89 along w/ DTP. Pt died 10-25-89. Autopsy = overwhelming strep. sepsis. MD and autopsy pathologist felt pt death not related to vaccination.


Changed on 12/30/2006

VAERS ID: 25556 Before After
VAERS Form:
Age:
Sex:Female
Location:New York
Vaccinated:1989-10-20
Onset:1989-10-25
Submitted:0000-00-00
Entered:1990-07-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: UNK. DTP / UNCLASSIFIED - / - - / -
MMR: MMR II / MSD 42622/1644R / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: SEPSIS

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1989-10-25
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:
Current Illness: no relevant history
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: autopsy-strep sepsis, The physician & autopsy pathologist felt that the pt''s pt''''s dealth was not related to vaccination.
CDC 'Split Type':

Write-up: MD reported pt initially vac. w/ MMR live at 15 mo''s mo''''s was vac. w/ booster MMR on 10-20-89 along w/ DTP. Pt died 10-25-89. Autopsy = overwhelming strep. sepsis. MD and autopsy pathologist felt pt death not related to vaccination.


Changed on 12/8/2009

VAERS ID: 25556 Before After
VAERS Form:
Age:
Sex:Female
Location:New York
Vaccinated:1989-10-20
Onset:1989-10-25
Submitted:0000-00-00
Entered:1990-07-24 1990-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: UNK. DTP DTP (NO BRAND NAME) / UNCLASSIFIED UNKNOWN MANUFACTURER - / - - / -
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 42622/1644R / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Sepsis, SEPSIS

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1989-10-25
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:
Current Illness: no relevant history
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: autopsy-strep sepsis, The physician & autopsy pathologist felt that the pt''''s pt''s dealth was not related to vaccination.
CDC 'Split Type': (blank) WAES89100782

Write-up: MD reported pt initially vac. w/ MMR live at 15 mo''''s mo''s was vac. w/ booster MMR on 10-20-89 along w/ DTP. Pt died 10-25-89. Autopsy = overwhelming strep. sepsis. MD and autopsy pathologist felt pt death not related to vaccination.


Changed on 5/14/2017

VAERS ID: 25556 Before After
VAERS Form:
Age:
Sex:Female
Location:New York
Vaccinated:1989-10-20
Onset:1989-10-25
Submitted:0000-00-00
Entered:1990-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 42622/1644R / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Sepsis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1989-10-25
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: ~ ()~~~In patient
Other Medications:
Current Illness: no relevant history
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: autopsy-strep sepsis, The physician & autopsy pathologist felt that the pt''s dealth was not related to vaccination.
CDC 'Split Type': WAES89100782

Write-up: MD reported pt initially vac. w/ MMR live at 15 mo''s was vac. w/ booster MMR on 10-20-89 along w/ DTP. Pt died 10-25-89. Autopsy = overwhelming strep. sepsis. MD and autopsy pathologist felt pt death not related to vaccination.


Changed on 9/14/2017

VAERS ID: 25556 Before After
VAERS Form:(blank) 1
Age:
Sex:Female
Location:New York
Vaccinated:1989-10-20
Onset:1989-10-25
Submitted:0000-00-00
Entered:1990-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 42622/1644R / - UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Sepsis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1989-10-25
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: ~ ()~~~In patient
Other Medications:
Current Illness: no relevant history
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: autopsy-strep sepsis, The physician & autopsy pathologist felt that the pt''s dealth was not related to vaccination.
CDC 'Split Type': WAES89100782

Write-up: MD reported pt initially vac. w/ MMR live at 15 mo''s was vac. w/ booster MMR on 10-20-89 along w/ DTP. Pt died 10-25-89. Autopsy = overwhelming strep. sepsis. MD and autopsy pathologist felt pt death not related to vaccination.


Changed on 2/14/2018

VAERS ID: 25556 Before After
VAERS Form:1
Age:
Sex:Female
Location:New York
Vaccinated:1989-10-20
Onset:1989-10-25
Submitted:0000-00-00
Entered:1990-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 42622/1644R / UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Sepsis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1989-10-25
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: ~ ()~~~In patient
Other Medications:
Current Illness: no relevant history
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: autopsy-strep sepsis, The physician & autopsy pathologist felt that the pt''s dealth was not related to vaccination.
CDC 'Split Type': WAES89100782

Write-up: MD reported pt initially vac. w/ MMR live at 15 mo''s was vac. w/ booster MMR on 10-20-89 along w/ DTP. Pt died 10-25-89. Autopsy = overwhelming strep. sepsis. MD and autopsy pathologist felt pt death not related to vaccination.


Changed on 6/14/2018

VAERS ID: 25556 Before After
VAERS Form:1
Age:
Sex:Female
Location:New York
Vaccinated:1989-10-20
Onset:1989-10-25
Submitted:0000-00-00
Entered:1990-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 42622/1644R / UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Sepsis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1989-10-25
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: ~ ()~~~In patient
Other Medications:
Current Illness: no relevant history
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: autopsy-strep sepsis, The physician & autopsy pathologist felt that the pt''s dealth was not related to vaccination.
CDC 'Split Type': WAES89100782

Write-up: MD reported pt initially vac. w/ MMR live at 15 mo''s was vac. w/ booster MMR on 10-20-89 along w/ DTP. Pt died 10-25-89. Autopsy = overwhelming strep. sepsis. MD and autopsy pathologist felt pt death not related to vaccination.


Changed on 8/14/2018

VAERS ID: 25556 Before After
VAERS Form:1
Age:
Sex:Female
Location:New York
Vaccinated:1989-10-20
Onset:1989-10-25
Submitted:0000-00-00
Entered:1990-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 42622/1644R / UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Sepsis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1989-10-25
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: ~ ()~~~In patient
Other Medications:
Current Illness: no relevant history
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: autopsy-strep sepsis, The physician & autopsy pathologist felt that the pt''s dealth was not related to vaccination.
CDC 'Split Type': WAES89100782

Write-up: MD reported pt initially vac. w/ MMR live at 15 mo''s was vac. w/ booster MMR on 10-20-89 along w/ DTP. Pt died 10-25-89. Autopsy = overwhelming strep. sepsis. MD and autopsy pathologist felt pt death not related to vaccination.


Changed on 9/14/2018

VAERS ID: 25556 Before After
VAERS Form:1
Age:
Sex:Female
Location:New York
Vaccinated:1989-10-20
Onset:1989-10-25
Submitted:0000-00-00
Entered:1990-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 42622/1644R / UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Sepsis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1989-10-25
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: ~ ()~~~In patient
Other Medications:
Current Illness: no relevant history
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: autopsy-strep sepsis, The physician & autopsy pathologist felt that the pt''s dealth was not related to vaccination.
CDC 'Split Type': WAES89100782

Write-up: MD reported pt initially vac. w/ MMR live at 15 mo''s was vac. w/ booster MMR on 10-20-89 along w/ DTP. Pt died 10-25-89. Autopsy = overwhelming strep. sepsis. MD and autopsy pathologist felt pt death not related to vaccination.


Changed on 10/14/2018

VAERS ID: 25556 Before After
VAERS Form:1
Age:
Sex:Female
Location:New York
Vaccinated:1989-10-20
Onset:1989-10-25
Submitted:0000-00-00
Entered:1990-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 42622/1644R / UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Sepsis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1989-10-25
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: ~ ()~~~In patient
Other Medications:
Current Illness: no relevant history
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: autopsy-strep sepsis, The physician & autopsy pathologist felt that the pt''s dealth was not related to vaccination.
CDC 'Split Type': WAES89100782

Write-up: MD reported pt initially vac. w/ MMR live at 15 mo''s was vac. w/ booster MMR on 10-20-89 along w/ DTP. Pt died 10-25-89. Autopsy = overwhelming strep. sepsis. MD and autopsy pathologist felt pt death not related to vaccination.

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