National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 440919

History of Changes from the VAERS Wayback Machine

First Appeared on 11/14/2011

VAERS ID: 440919
VAERS Form:
Age:1.0
Sex:Female
Location:California
Vaccinated:2011-10-10
Onset:2011-10-20
Submitted:2011-10-25
Entered:2011-11-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U4184BB / - RL / IM
HIBV: HIB (HIBERIX) / GLAXOSMITHKLINE BIOLOGICALS AHIBC291BA / - LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0047AA / 0 LL / SC
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 916922 / - RL / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0338AA / 0 RL / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Asthenia, Brain herniation, Diarrhoea, Hydrocephalus, Posturing, Pyrexia, Rash, Unresponsive to stimuli, Ventricular cisternostomy, Vomiting, Brain oedema, CSF test, Viral test, Endotracheal intubation

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Seckel syndrome or osteodysplastic primordial dwarfism
Allergies:
Diagnostic Lab Data: California encephalitis panel; CSF
CDC 'Split Type':

Write-up: Patient with likely osteodysplastic primary dwarfism began to have vomiting, diarrhea, rash, fever on 10/20, became progressively weaker. Seen in urgent care clinic 10/23, became very weak after home on BENADRYL, came to ER. Found to have hydrocephalus (more than previous MRI), decorticate posturing, intubated, ventriculostomy perform, no longer responsive, cerebral edema and herniation.


Changed on 1/15/2012

VAERS ID: 440919 Before After
VAERS Form:
Age:1.0
Sex:Female
Location:California
Vaccinated:2011-10-10
Onset:2011-10-20
Submitted:2011-10-25
Entered:2011-11-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U4184BB / - RL / IM
HIBV: HIB (HIBERIX) / GLAXOSMITHKLINE BIOLOGICALS AHIBC291BA / - LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0047AA / 0 LL / SC
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 916922 / - RL / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0338AA / 0 RL / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Asthenia, Brain herniation, Diarrhoea, Hydrocephalus, Posturing, Pyrexia, Rash, Unresponsive to stimuli, Ventricular cisternostomy, Vomiting, Brain oedema, CSF test, Viral test, Endotracheal intubation

Life Threatening? Yes
Birth Defect? No
Died? No Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Seckel syndrome or osteodysplastic primordial dwarfism
Allergies:
Diagnostic Lab Data: California encephalitis panel; CSF
CDC 'Split Type':

Write-up: Patient with likely osteodysplastic primary dwarfism began to have vomiting, diarrhea, rash, fever on 10/20, became progressively weaker. Seen in urgent care clinic 10/23, became very weak after home on BENADRYL, came to ER. Found to have hydrocephalus (more than previous MRI), decorticate posturing, intubated, ventriculostomy perform, no longer responsive, cerebral edema and herniation.


Changed on 7/7/2013

VAERS ID: 440919 Before After
VAERS Form:
Age:1.0
Sex:Female
Location:California
Vaccinated:2011-10-10
Onset:2011-10-20
Submitted:2011-10-25
Entered:2011-11-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U4184BB / - RL / IM
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U4184BB / - RL / IM
HIBV: HIB (HIBERIX) / GLAXOSMITHKLINE BIOLOGICALS AHIBC291BA / - LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0047AA / 0 LL / SC
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 916922 / - RL / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0338AA / 0 RL / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Asthenia, Brain herniation, Diarrhoea, Hydrocephalus, Posturing, Pyrexia, Rash, Unresponsive to stimuli, Ventricular cisternostomy, Vomiting, Brain oedema, CSF test, Viral test, Endotracheal intubation

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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Seckel syndrome or osteodysplastic primordial dwarfism
Allergies:
Diagnostic Lab Data: California encephalitis panel; CSF
CDC 'Split Type':

Write-up: Patient with likely osteodysplastic primary dwarfism began to have vomiting, diarrhea, rash, fever on 10/20, became progressively weaker. Seen in urgent care clinic 10/23, became very weak after home on BENADRYL, came to ER. Found to have hydrocephalus (more than previous MRI), decorticate posturing, intubated, ventriculostomy perform, no longer responsive, cerebral edema and herniation.


Changed on 2/14/2017

VAERS ID: 440919 Before After
VAERS Form:
Age:1.0 1.01
Sex:Female
Location:California
Vaccinated:2011-10-10
Onset:2011-10-20
Submitted:2011-10-25
Entered:2011-11-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U4184BB / - RL / IM
HIBV: HIB (HIBERIX) / GLAXOSMITHKLINE BIOLOGICALS AHIBC291BA / - LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0047AA / 0 LL / SC
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 916922 / - RL / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0338AA / 0 RL / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Asthenia, Brain herniation, Diarrhoea, Hydrocephalus, Posturing, Pyrexia, Rash, Unresponsive to stimuli, Ventricular cisternostomy, Vomiting, Brain oedema, CSF test, Viral test, Endotracheal intubation

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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Seckel syndrome or osteodysplastic primordial dwarfism
Allergies:
Diagnostic Lab Data: California encephalitis panel; CSF
CDC 'Split Type':

Write-up: Patient with likely osteodysplastic primary dwarfism began to have vomiting, diarrhea, rash, fever on 10/20, became progressively weaker. Seen in urgent care clinic 10/23, became very weak after home on BENADRYL, came to ER. Found to have hydrocephalus (more than previous MRI), decorticate posturing, intubated, ventriculostomy perform, no longer responsive, cerebral edema and herniation.


Changed on 9/14/2017

VAERS ID: 440919 Before After
VAERS Form:(blank) 1
Age:1.01
Sex:Female
Location:California
Vaccinated:2011-10-10
Onset:2011-10-20
Submitted:2011-10-25
Entered:2011-11-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U4184BB / - UNK RL / IM
HIBV: HIB (HIBERIX) / GLAXOSMITHKLINE BIOLOGICALS AHIBC291BA / - UNK LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0047AA / 0 1 LL / SC
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 916922 / - UNK RL / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0338AA / 0 1 RL / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Asthenia, Brain herniation, Diarrhoea, Hydrocephalus, Posturing, Pyrexia, Rash, Unresponsive to stimuli, Ventricular cisternostomy, Vomiting, Brain oedema, CSF test, Viral test, Endotracheal intubation

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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Seckel syndrome or osteodysplastic primordial dwarfism
Allergies:
Diagnostic Lab Data: California encephalitis panel; CSF
CDC 'Split Type':

Write-up: Patient with likely osteodysplastic primary dwarfism began to have vomiting, diarrhea, rash, fever on 10/20, became progressively weaker. Seen in urgent care clinic 10/23, became very weak after home on BENADRYL, came to ER. Found to have hydrocephalus (more than previous MRI), decorticate posturing, intubated, ventriculostomy perform, no longer responsive, cerebral edema and herniation.


Changed on 2/14/2018

VAERS ID: 440919 Before After
VAERS Form:1
Age:1.01
Sex:Female
Location:California
Vaccinated:2011-10-10
Onset:2011-10-20
Submitted:2011-10-25
Entered:2011-11-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U4184BB / UNK RL / IM
HIBV: HIB (HIBERIX) / GLAXOSMITHKLINE BIOLOGICALS AHIBC291BA / UNK LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0047AA / 1 LL / SC
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 916922 / UNK RL / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0338AA / 1 RL / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Asthenia, Brain herniation, Diarrhoea, Hydrocephalus, Posturing, Pyrexia, Rash, Unresponsive to stimuli, Ventricular cisternostomy, Vomiting, Brain oedema, CSF test, Viral test, Endotracheal intubation

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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Seckel syndrome or osteodysplastic primordial dwarfism
Allergies:
Diagnostic Lab Data: California encephalitis panel; CSF
CDC 'Split Type':

Write-up: Patient with likely osteodysplastic primary dwarfism began to have vomiting, diarrhea, rash, fever on 10/20, became progressively weaker. Seen in urgent care clinic 10/23, became very weak after home on BENADRYL, came to ER. Found to have hydrocephalus (more than previous MRI), decorticate posturing, intubated, ventriculostomy perform, no longer responsive, cerebral edema and herniation.


Changed on 6/14/2018

VAERS ID: 440919 Before After
VAERS Form:1
Age:1.01
Sex:Female
Location:California
Vaccinated:2011-10-10
Onset:2011-10-20
Submitted:2011-10-25
Entered:2011-11-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U4184BB / UNK RL / IM
HIBV: HIB (HIBERIX) / GLAXOSMITHKLINE BIOLOGICALS AHIBC291BA / UNK LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0047AA / 1 LL / SC
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 916922 / UNK RL / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0338AA / 1 RL / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Asthenia, Brain herniation, Diarrhoea, Hydrocephalus, Posturing, Pyrexia, Rash, Unresponsive to stimuli, Ventricular cisternostomy, Vomiting, Brain oedema, CSF test, Viral test, Endotracheal intubation

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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Seckel syndrome or osteodysplastic primordial dwarfism
Allergies:
Diagnostic Lab Data: California encephalitis panel; CSF
CDC 'Split Type':

Write-up: Patient with likely osteodysplastic primary dwarfism began to have vomiting, diarrhea, rash, fever on 10/20, became progressively weaker. Seen in urgent care clinic 10/23, became very weak after home on BENADRYL, came to ER. Found to have hydrocephalus (more than previous MRI), decorticate posturing, intubated, ventriculostomy perform, no longer responsive, cerebral edema and herniation.


Changed on 8/14/2018

VAERS ID: 440919 Before After
VAERS Form:1
Age:1.01
Sex:Female
Location:California
Vaccinated:2011-10-10
Onset:2011-10-20
Submitted:2011-10-25
Entered:2011-11-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U4184BB / UNK RL / IM
HIBV: HIB (HIBERIX) / GLAXOSMITHKLINE BIOLOGICALS AHIBC291BA / UNK LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0047AA / 1 LL / SC
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 916922 / UNK RL / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0338AA / 1 RL / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Asthenia, Brain herniation, Diarrhoea, Hydrocephalus, Posturing, Pyrexia, Rash, Unresponsive to stimuli, Ventricular cisternostomy, Vomiting, Brain oedema, CSF test, Viral test, Endotracheal intubation

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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Seckel syndrome or osteodysplastic primordial dwarfism
Allergies:
Diagnostic Lab Data: California encephalitis panel; CSF
CDC 'Split Type':

Write-up: Patient with likely osteodysplastic primary dwarfism began to have vomiting, diarrhea, rash, fever on 10/20, became progressively weaker. Seen in urgent care clinic 10/23, became very weak after home on BENADRYL, came to ER. Found to have hydrocephalus (more than previous MRI), decorticate posturing, intubated, ventriculostomy perform, no longer responsive, cerebral edema and herniation.


Changed on 9/14/2018

VAERS ID: 440919 Before After
VAERS Form:1
Age:1.01
Sex:Female
Location:California
Vaccinated:2011-10-10
Onset:2011-10-20
Submitted:2011-10-25
Entered:2011-11-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U4184BB / UNK RL / IM
HIBV: HIB (HIBERIX) / GLAXOSMITHKLINE BIOLOGICALS AHIBC291BA / UNK LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0047AA / 1 LL / SC
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 916922 / UNK RL / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0338AA / 1 RL / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Asthenia, Brain herniation, Diarrhoea, Hydrocephalus, Posturing, Pyrexia, Rash, Unresponsive to stimuli, Ventricular cisternostomy, Vomiting, Brain oedema, CSF test, Viral test, Endotracheal intubation

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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Seckel syndrome or osteodysplastic primordial dwarfism
Allergies:
Diagnostic Lab Data: California encephalitis panel; CSF
CDC 'Split Type':

Write-up: Patient with likely osteodysplastic primary dwarfism began to have vomiting, diarrhea, rash, fever on 10/20, became progressively weaker. Seen in urgent care clinic 10/23, became very weak after home on BENADRYL, came to ER. Found to have hydrocephalus (more than previous MRI), decorticate posturing, intubated, ventriculostomy perform, no longer responsive, cerebral edema and herniation.


Changed on 10/14/2018

VAERS ID: 440919 Before After
VAERS Form:1
Age:1.01
Sex:Female
Location:California
Vaccinated:2011-10-10
Onset:2011-10-20
Submitted:2011-10-25
Entered:2011-11-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U4184BB / UNK RL / IM
HIBV: HIB (HIBERIX) / GLAXOSMITHKLINE BIOLOGICALS AHIBC291BA / UNK LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0047AA / 1 LL / SC
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 916922 / UNK RL / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0338AA / 1 RL / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Asthenia, Brain herniation, Diarrhoea, Hydrocephalus, Posturing, Pyrexia, Rash, Unresponsive to stimuli, Ventricular cisternostomy, Vomiting, Brain oedema, CSF test, Viral test, Endotracheal intubation

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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Seckel syndrome or osteodysplastic primordial dwarfism
Allergies:
Diagnostic Lab Data: California encephalitis panel; CSF
CDC 'Split Type':

Write-up: Patient with likely osteodysplastic primary dwarfism began to have vomiting, diarrhea, rash, fever on 10/20, became progressively weaker. Seen in urgent care clinic 10/23, became very weak after home on BENADRYL, came to ER. Found to have hydrocephalus (more than previous MRI), decorticate posturing, intubated, ventriculostomy perform, no longer responsive, cerebral edema and herniation.

New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=440919&WAYBACKHISTORY=ON


Copyright © 2020 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166