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This is VAERS ID 261871

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 261871
VAERS Form:
Age:43.0
Sex:Female
Location:Maryland
Vaccinated:2006-08-18
Onset:2006-08-18
Submitted:2006-08-21
Entered:2006-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE AHBVB288AA / 1 RA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0215F / - LA / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Cardiac arrest, Convulsion

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2006-08-18
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 KNOWN
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Received MMR vaccine and Hepatitis B vaccine at 1:45 PM. Brought in to ER at 10:48 PM in full cardiac arrest. Apparently had witnessed seizure prior to arrest.


Changed on 12/8/2009

VAERS ID: 261871 Before After
VAERS Form:
Age:43.0
Sex:Female
Location:Maryland
Vaccinated:2006-08-18
Onset:2006-08-18
Submitted:2006-08-21
Entered:2006-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE GLAXOSMITHKLINE BIOLOGICALS AHBVB288AA / 1 RA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0215F / - LA / SC

Administered by: Private      Purchased by: Unknown Private
Symptoms: Cardiac arrest, Convulsion

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2006-08-18
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 KNOWN
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Received MMR vaccine and Hepatitis B vaccine at 1:45 PM. Brought in to ER at 10:48 PM in full cardiac arrest. Apparently had witnessed seizure prior to arrest.


Changed on 9/14/2017

VAERS ID: 261871 Before After
VAERS Form:(blank) 1
Age:43.0
Sex:Female
Location:Maryland
Vaccinated:2006-08-18
Onset:2006-08-18
Submitted:2006-08-21
Entered:2006-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVB288AA / 1 2 RA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0215F / - UNK LA / SC

Administered by: Private      Purchased by: Private
Symptoms: Cardiac arrest, Convulsion

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2006-08-18
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 KNOWN
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Received MMR vaccine and Hepatitis B vaccine at 1:45 PM. Brought in to ER at 10:48 PM in full cardiac arrest. Apparently had witnessed seizure prior to arrest.


Changed on 2/14/2018

VAERS ID: 261871 Before After
VAERS Form:1
Age:43.0
Sex:Female
Location:Maryland
Vaccinated:2006-08-18
Onset:2006-08-18
Submitted:2006-08-21
Entered:2006-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVB288AA / 2 RA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0215F / UNK LA / SC

Administered by: Private      Purchased by: Private
Symptoms: Cardiac arrest, Convulsion

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2006-08-18
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 KNOWN
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Received MMR vaccine and Hepatitis B vaccine at 1:45 PM. Brought in to ER at 10:48 PM in full cardiac arrest. Apparently had witnessed seizure prior to arrest.


Changed on 6/14/2018

VAERS ID: 261871 Before After
VAERS Form:1
Age:43.0
Sex:Female
Location:Maryland
Vaccinated:2006-08-18
Onset:2006-08-18
Submitted:2006-08-21
Entered:2006-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVB288AA / 2 RA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0215F / UNK LA / SC

Administered by: Private      Purchased by: Private
Symptoms: Cardiac arrest, Convulsion

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2006-08-18
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 KNOWN
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Received MMR vaccine and Hepatitis B vaccine at 1:45 PM. Brought in to ER at 10:48 PM in full cardiac arrest. Apparently had witnessed seizure prior to arrest.


Changed on 8/14/2018

VAERS ID: 261871 Before After
VAERS Form:1
Age:43.0
Sex:Female
Location:Maryland
Vaccinated:2006-08-18
Onset:2006-08-18
Submitted:2006-08-21
Entered:2006-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVB288AA / 2 RA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0215F / UNK LA / SC

Administered by: Private      Purchased by: Private
Symptoms: Cardiac arrest, Convulsion

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2006-08-18
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 KNOWN
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Received MMR vaccine and Hepatitis B vaccine at 1:45 PM. Brought in to ER at 10:48 PM in full cardiac arrest. Apparently had witnessed seizure prior to arrest.


Changed on 9/14/2018

VAERS ID: 261871 Before After
VAERS Form:1
Age:43.0
Sex:Female
Location:Maryland
Vaccinated:2006-08-18
Onset:2006-08-18
Submitted:2006-08-21
Entered:2006-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVB288AA / 2 RA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0215F / UNK LA / SC

Administered by: Private      Purchased by: Private
Symptoms: Cardiac arrest, Convulsion

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2006-08-18
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 KNOWN
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Received MMR vaccine and Hepatitis B vaccine at 1:45 PM. Brought in to ER at 10:48 PM in full cardiac arrest. Apparently had witnessed seizure prior to arrest.


Changed on 10/14/2018

VAERS ID: 261871 Before After
VAERS Form:1
Age:43.0
Sex:Female
Location:Maryland
Vaccinated:2006-08-18
Onset:2006-08-18
Submitted:2006-08-21
Entered:2006-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVB288AA / 2 RA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0215F / UNK LA / SC

Administered by: Private      Purchased by: Private
Symptoms: Cardiac arrest, Convulsion

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2006-08-18
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 KNOWN
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Received MMR vaccine and Hepatitis B vaccine at 1:45 PM. Brought in to ER at 10:48 PM in full cardiac arrest. Apparently had witnessed seizure prior to arrest.

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