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This is VAERS ID 540483

History of Changes from the VAERS Wayback Machine

First Appeared on 9/14/2014

VAERS ID: 540483
VAERS Form:
Age:0.9
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2014-08-19
Entered:2014-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEN: MENINGOCOCCAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Blindness, Convulsion, Death, Posture abnormal, Ventriculo-peritoneal shunt, Gastrostomy, Brain death

Life Threatening? No
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: UNK
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Lab tests unknown
CDC 'Split Type': 2014SA110867

Write-up: Initial report received from a consumer, who is also the patient''s mother, on 14 August 2014. The following is verbatim from the report: "I lost my son at year and a half. But after 10 months. After he got the meningitis enoculation. He became brain dead blind dead outward posturing constant seizes. Gastrostomy tube and a shunt in his brain. Shot was what killed him. Panhandlers health." No further information was available at the time of the report. The patient outcome was fatal. Documents held by sender: None.


Changed on 9/14/2017

VAERS ID: 540483 Before After
VAERS Form:(blank) 1
Age:0.9
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2014-08-19
Entered:2014-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEN: MENINGOCOCCAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Blindness, Convulsion, Death, Posture abnormal, Ventriculo-peritoneal shunt, Gastrostomy, Brain death

Life Threatening? No
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: UNK
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Lab tests unknown
CDC 'Split Type': 2014SA110867

Write-up: Initial report received from a consumer, who is also the patient''s mother, on 14 August 2014. The following is verbatim from the report: "I lost my son at year and a half. But after 10 months. After he got the meningitis enoculation. He became brain dead blind dead outward posturing constant seizes. Gastrostomy tube and a shunt in his brain. Shot was what killed him. Panhandlers health." No further information was available at the time of the report. The patient outcome was fatal. Documents held by sender: None.


Changed on 2/14/2018

VAERS ID: 540483 Before After
VAERS Form:1
Age:0.9
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2014-08-19
Entered:2014-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEN: MENINGOCOCCAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Blindness, Convulsion, Death, Posture abnormal, Ventriculo-peritoneal shunt, Gastrostomy, Brain death

Life Threatening? No
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: UNK
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Lab tests unknown
CDC 'Split Type': 2014SA110867

Write-up: Initial report received from a consumer, who is also the patient''s mother, on 14 August 2014. The following is verbatim from the report: "I lost my son at year and a half. But after 10 months. After he got the meningitis enoculation. He became brain dead blind dead outward posturing constant seizes. Gastrostomy tube and a shunt in his brain. Shot was what killed him. Panhandlers health." No further information was available at the time of the report. The patient outcome was fatal. Documents held by sender: None.


Changed on 6/14/2018

VAERS ID: 540483 Before After
VAERS Form:1
Age:0.9
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2014-08-19
Entered:2014-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEN: MENINGOCOCCAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Blindness, Convulsion, Death, Posture abnormal, Ventriculo-peritoneal shunt, Gastrostomy, Brain death

Life Threatening? No
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: UNK
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Lab tests unknown
CDC 'Split Type': 2014SA110867

Write-up: Initial report received from a consumer, who is also the patient''s mother, on 14 August 2014. The following is verbatim from the report: "I lost my son at year and a half. But after 10 months. After he got the meningitis enoculation. He became brain dead blind dead outward posturing constant seizes. Gastrostomy tube and a shunt in his brain. Shot was what killed him. Panhandlers health." No further information was available at the time of the report. The patient outcome was fatal. Documents held by sender: None.


Changed on 8/14/2018

VAERS ID: 540483 Before After
VAERS Form:1
Age:0.9
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2014-08-19
Entered:2014-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEN: MENINGOCOCCAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Blindness, Convulsion, Death, Posture abnormal, Ventriculo-peritoneal shunt, Gastrostomy, Brain death

Life Threatening? No
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: UNK
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Lab tests unknown
CDC 'Split Type': 2014SA110867

Write-up: Initial report received from a consumer, who is also the patient''s mother, on 14 August 2014. The following is verbatim from the report: "I lost my son at year and a half. But after 10 months. After he got the meningitis enoculation. He became brain dead blind dead outward posturing constant seizes. Gastrostomy tube and a shunt in his brain. Shot was what killed him. Panhandlers health." No further information was available at the time of the report. The patient outcome was fatal. Documents held by sender: None.


Changed on 9/14/2018

VAERS ID: 540483 Before After
VAERS Form:1
Age:0.9
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2014-08-19
Entered:2014-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEN: MENINGOCOCCAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Blindness, Convulsion, Death, Posture abnormal, Ventriculo-peritoneal shunt, Gastrostomy, Brain death

Life Threatening? No
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: UNK
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Lab tests unknown
CDC 'Split Type': 2014SA110867

Write-up: Initial report received from a consumer, who is also the patient''s mother, on 14 August 2014. The following is verbatim from the report: "I lost my son at year and a half. But after 10 months. After he got the meningitis enoculation. He became brain dead blind dead outward posturing constant seizes. Gastrostomy tube and a shunt in his brain. Shot was what killed him. Panhandlers health." No further information was available at the time of the report. The patient outcome was fatal. Documents held by sender: None.


Changed on 10/14/2018

VAERS ID: 540483 Before After
VAERS Form:1
Age:0.9
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2014-08-19
Entered:2014-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEN: MENINGOCOCCAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Blindness, Convulsion, Death, Posture abnormal, Ventriculo-peritoneal shunt, Gastrostomy, Brain death

Life Threatening? No
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: UNK
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Lab tests unknown
CDC 'Split Type': 2014SA110867

Write-up: Initial report received from a consumer, who is also the patient''s mother, on 14 August 2014. The following is verbatim from the report: "I lost my son at year and a half. But after 10 months. After he got the meningitis enoculation. He became brain dead blind dead outward posturing constant seizes. Gastrostomy tube and a shunt in his brain. Shot was what killed him. Panhandlers health." No further information was available at the time of the report. The patient outcome was fatal. Documents held by sender: None.

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=540483&WAYBACKHISTORY=ON


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