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This is VAERS ID 28906

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 28906
VAERS Form:
Age:15.1
Sex:Female
Location:Pennsylvania
Vaccinated:1989-12-08
Onset:1989-12-27
Submitted:1991-02-27
Entered:1991-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II / MSD 1471P / 0 LA / SC

Administered by: Public      Purchased by: Unknown
Symptoms: HEADACHE

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1989-12-27
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: NONE
Other Medications: Finlepsen (Carbamazepine)
Current Illness: NONE
Preexisting Conditions: Epilepsy listed in autopsy as basic cause of death.
Allergies:
Diagnostic Lab Data: pt did not seek medical attention. No tests performed p/vax was administered.
CDC 'Split Type': Epilepsy listed in autopsy as basic cause of death.

Write-up: Five days p/MMR vax was administered, pt experienced recurring headaches which continued until her death.


Changed on 12/8/2009

VAERS ID: 28906 Before After
VAERS Form:
Age:15.1
Sex:Female
Location:Pennsylvania
Vaccinated:1989-12-08
Onset:1989-12-27
Submitted:1991-02-27
Entered:1991-03-15 1991-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 1471P / 0 LA / SC

Administered by: Public      Purchased by: Unknown Public
Symptoms: Headache, HEADACHE

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1989-12-27
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: NONE
Other Medications: Finlepsen (Carbamazepine)
Current Illness: NONE
Preexisting Conditions: Epilepsy listed in autopsy as basic cause of death.
Allergies:
Diagnostic Lab Data: pt did not seek medical attention. No tests performed p/vax was administered.
CDC 'Split Type': Epilepsy listed in autopsy as basic cause of death. (blank)

Write-up: Five days p/MMR vax was administered, pt experienced recurring headaches which continued until her death.


Changed on 2/14/2017

VAERS ID: 28906 Before After
VAERS Form:
Age:15.1 15.0
Sex:Female
Location:Pennsylvania
Vaccinated:1989-12-08
Onset:1989-12-27
Submitted:1991-02-27
Entered:1991-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1471P / 0 LA / SC

Administered by: Public      Purchased by: Public
Symptoms: Headache

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1989-12-27
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: NONE
Other Medications: Finlepsen (Carbamazepine)
Current Illness: NONE
Preexisting Conditions: Epilepsy listed in autopsy as basic cause of death.
Allergies:
Diagnostic Lab Data: pt did not seek medical attention. No tests performed p/vax was administered.
CDC 'Split Type':

Write-up: Five days p/MMR vax was administered, pt experienced recurring headaches which continued until her death.


Changed on 5/14/2017

VAERS ID: 28906 Before After
VAERS Form:
Age:15.0
Sex:Female
Location:Pennsylvania
Vaccinated:1989-12-08
Onset:1989-12-27
Submitted:1991-02-27
Entered:1991-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1471P / 0 LA / SC

Administered by: Public      Purchased by: Public
Symptoms: Headache

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1989-12-27
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: NONE NONE~ ()~~~In patient
Other Medications: Finlepsen (Carbamazepine)
Current Illness: NONE
Preexisting Conditions: Epilepsy listed in autopsy as basic cause of death.
Allergies:
Diagnostic Lab Data: pt did not seek medical attention. No tests performed p/vax was administered.
CDC 'Split Type':

Write-up: Five days p/MMR vax was administered, pt experienced recurring headaches which continued until her death.


Changed on 9/14/2017

VAERS ID: 28906 Before After
VAERS Form:(blank) 1
Age:15.0
Sex:Female
Location:Pennsylvania
Vaccinated:1989-12-08
Onset:1989-12-27
Submitted:1991-02-27
Entered:1991-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1471P / 0 1 LA / SC

Administered by: Public      Purchased by: Public
Symptoms: Headache

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1989-12-27
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: NONE~ ()~~~In patient
Other Medications: Finlepsen (Carbamazepine)
Current Illness: NONE
Preexisting Conditions: Epilepsy listed in autopsy as basic cause of death.
Allergies:
Diagnostic Lab Data: pt did not seek medical attention. No tests performed p/vax was administered.
CDC 'Split Type':

Write-up: Five days p/MMR vax was administered, pt experienced recurring headaches which continued until her death.


Changed on 2/14/2018

VAERS ID: 28906 Before After
VAERS Form:1
Age:15.0
Sex:Female
Location:Pennsylvania
Vaccinated:1989-12-08
Onset:1989-12-27
Submitted:1991-02-27
Entered:1991-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1471P / 1 LA / SC

Administered by: Public      Purchased by: Public
Symptoms: Headache

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1989-12-27
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: NONE~ ()~~~In patient
Other Medications: Finlepsen (Carbamazepine)
Current Illness: NONE
Preexisting Conditions: Epilepsy listed in autopsy as basic cause of death.
Allergies:
Diagnostic Lab Data: pt did not seek medical attention. No tests performed p/vax was administered.
CDC 'Split Type':

Write-up: Five days p/MMR vax was administered, pt experienced recurring headaches which continued until her death.


Changed on 6/14/2018

VAERS ID: 28906 Before After
VAERS Form:1
Age:15.0
Sex:Female
Location:Pennsylvania
Vaccinated:1989-12-08
Onset:1989-12-27
Submitted:1991-02-27
Entered:1991-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1471P / 1 LA / SC

Administered by: Public      Purchased by: Public
Symptoms: Headache

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1989-12-27
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: NONE~ ()~~~In patient
Other Medications: Finlepsen (Carbamazepine)
Current Illness: NONE
Preexisting Conditions: Epilepsy listed in autopsy as basic cause of death.
Allergies:
Diagnostic Lab Data: pt did not seek medical attention. No tests performed p/vax was administered.
CDC 'Split Type':

Write-up: Five days p/MMR vax was administered, pt experienced recurring headaches which continued until her death.


Changed on 8/14/2018

VAERS ID: 28906 Before After
VAERS Form:1
Age:15.0
Sex:Female
Location:Pennsylvania
Vaccinated:1989-12-08
Onset:1989-12-27
Submitted:1991-02-27
Entered:1991-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1471P / 1 LA / SC

Administered by: Public      Purchased by: Public
Symptoms: Headache

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1989-12-27
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: NONE~ ()~~~In patient
Other Medications: Finlepsen (Carbamazepine)
Current Illness: NONE
Preexisting Conditions: Epilepsy listed in autopsy as basic cause of death.
Allergies:
Diagnostic Lab Data: pt did not seek medical attention. No tests performed p/vax was administered.
CDC 'Split Type':

Write-up: Five days p/MMR vax was administered, pt experienced recurring headaches which continued until her death.


Changed on 9/14/2018

VAERS ID: 28906 Before After
VAERS Form:1
Age:15.0
Sex:Female
Location:Pennsylvania
Vaccinated:1989-12-08
Onset:1989-12-27
Submitted:1991-02-27
Entered:1991-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1471P / 1 LA / SC

Administered by: Public      Purchased by: Public
Symptoms: Headache

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1989-12-27
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: NONE~ ()~~~In patient
Other Medications: Finlepsen (Carbamazepine)
Current Illness: NONE
Preexisting Conditions: Epilepsy listed in autopsy as basic cause of death.
Allergies:
Diagnostic Lab Data: pt did not seek medical attention. No tests performed p/vax was administered.
CDC 'Split Type':

Write-up: Five days p/MMR vax was administered, pt experienced recurring headaches which continued until her death.


Changed on 10/14/2018

VAERS ID: 28906 Before After
VAERS Form:1
Age:15.0
Sex:Female
Location:Pennsylvania
Vaccinated:1989-12-08
Onset:1989-12-27
Submitted:1991-02-27
Entered:1991-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1471P / 1 LA / SC

Administered by: Public      Purchased by: Public
Symptoms: Headache

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1989-12-27
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: NONE~ ()~~~In patient
Other Medications: Finlepsen (Carbamazepine)
Current Illness: NONE
Preexisting Conditions: Epilepsy listed in autopsy as basic cause of death.
Allergies:
Diagnostic Lab Data: pt did not seek medical attention. No tests performed p/vax was administered.
CDC 'Split Type':

Write-up: Five days p/MMR vax was administered, pt experienced recurring headaches which continued until her death.

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