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This is VAERS ID 264460

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 264460
VAERS Form:
Age:4.0
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2006-10-09
Entered:2006-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / - UN / -

Administered by: Other      Purchased by: Unknown
Symptoms: Unevaluable event

Life Threatening? Yes
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: Unknown
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Information has been received from a certified medical assistant concerning a 4-year-old female who in approximately 2002 was vaccinated with a dose of measles virus vaccine live (+) mumps virus vaccine live (+0 rubella virus vaccine live. In approximate"ly 2002, suddenly after the vaccine was given, the patient died. The child''''s autopsy was inconclusive. No other information was available. There was no product quality complaint. The event was also considered to be immediately life-threatening by th


Changed on 12/8/2009

VAERS ID: 264460 Before After
VAERS Form:
Age:4.0
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2006-10-09
Entered:2006-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / - UN / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Unevaluable event

Life Threatening? Yes
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: Unknown
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) WAES0610USA03251

Write-up: Information has been received from a certified medical assistant concerning a 4-year-old female who in approximately 2002 was vaccinated with a dose of measles virus vaccine live (+) mumps virus vaccine live (+0 rubella virus vaccine live. In approximate"ly approximately 2002, suddenly after the vaccine was given, the patient died. The child''''s child''s autopsy was inconclusive. No other information was available. There was no product quality complaint. The event was also considered to be immediately life-threatening by th the reporter. Additional information has been requested.


Changed on 9/14/2017

VAERS ID: 264460 Before After
VAERS Form:(blank) 1
Age:4.0
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2006-10-09
Entered:2006-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / - UNK UN / -

Administered by: Other      Purchased by: Other
Symptoms: Unevaluable event

Life Threatening? Yes
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: Unknown
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0610USA03251

Write-up: Information has been received from a certified medical assistant concerning a 4-year-old female who in approximately 2002 was vaccinated with a dose of measles virus vaccine live (+) mumps virus vaccine live (+0 rubella virus vaccine live. In approximately 2002, suddenly after the vaccine was given, the patient died. The child''s autopsy was inconclusive. No other information was available. There was no product quality complaint. The event was also considered to be immediately life-threatening by the reporter. Additional information has been requested.


Changed on 2/14/2018

VAERS ID: 264460 Before After
VAERS Form:1
Age:4.0
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2006-10-09
Entered:2006-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK UN / -

Administered by: Other      Purchased by: Other
Symptoms: Unevaluable event

Life Threatening? Yes
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: Unknown
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0610USA03251

Write-up: Information has been received from a certified medical assistant concerning a 4-year-old female who in approximately 2002 was vaccinated with a dose of measles virus vaccine live (+) mumps virus vaccine live (+0 rubella virus vaccine live. In approximately 2002, suddenly after the vaccine was given, the patient died. The child''s autopsy was inconclusive. No other information was available. There was no product quality complaint. The event was also considered to be immediately life-threatening by the reporter. Additional information has been requested.


Changed on 6/14/2018

VAERS ID: 264460 Before After
VAERS Form:1
Age:4.0
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2006-10-09
Entered:2006-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK UN / -

Administered by: Other      Purchased by: Other
Symptoms: Unevaluable event

Life Threatening? Yes
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: Unknown
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0610USA03251

Write-up: Information has been received from a certified medical assistant concerning a 4-year-old female who in approximately 2002 was vaccinated with a dose of measles virus vaccine live (+) mumps virus vaccine live (+0 rubella virus vaccine live. In approximately 2002, suddenly after the vaccine was given, the patient died. The child''s autopsy was inconclusive. No other information was available. There was no product quality complaint. The event was also considered to be immediately life-threatening by the reporter. Additional information has been requested.


Changed on 8/14/2018

VAERS ID: 264460 Before After
VAERS Form:1
Age:4.0
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2006-10-09
Entered:2006-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK UN / -

Administered by: Other      Purchased by: Other
Symptoms: Unevaluable event

Life Threatening? Yes
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: Unknown
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0610USA03251

Write-up: Information has been received from a certified medical assistant concerning a 4-year-old female who in approximately 2002 was vaccinated with a dose of measles virus vaccine live (+) mumps virus vaccine live (+0 rubella virus vaccine live. In approximately 2002, suddenly after the vaccine was given, the patient died. The child''s autopsy was inconclusive. No other information was available. There was no product quality complaint. The event was also considered to be immediately life-threatening by the reporter. Additional information has been requested.


Changed on 9/14/2018

VAERS ID: 264460 Before After
VAERS Form:1
Age:4.0
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2006-10-09
Entered:2006-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK UN / -

Administered by: Other      Purchased by: Other
Symptoms: Unevaluable event

Life Threatening? Yes
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: Unknown
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0610USA03251

Write-up: Information has been received from a certified medical assistant concerning a 4-year-old female who in approximately 2002 was vaccinated with a dose of measles virus vaccine live (+) mumps virus vaccine live (+0 rubella virus vaccine live. In approximately 2002, suddenly after the vaccine was given, the patient died. The child''s autopsy was inconclusive. No other information was available. There was no product quality complaint. The event was also considered to be immediately life-threatening by the reporter. Additional information has been requested.


Changed on 10/14/2018

VAERS ID: 264460 Before After
VAERS Form:1
Age:4.0
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2006-10-09
Entered:2006-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK UN / -

Administered by: Other      Purchased by: Other
Symptoms: Unevaluable event

Life Threatening? Yes
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: Unknown
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0610USA03251

Write-up: Information has been received from a certified medical assistant concerning a 4-year-old female who in approximately 2002 was vaccinated with a dose of measles virus vaccine live (+) mumps virus vaccine live (+0 rubella virus vaccine live. In approximately 2002, suddenly after the vaccine was given, the patient died. The child''s autopsy was inconclusive. No other information was available. There was no product quality complaint. The event was also considered to be immediately life-threatening by the reporter. Additional information has been requested.

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