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This is VAERS ID 63044

(NOTE: This result is from the 2/14/2017 version of the VAERS database)

Case Details

VAERS ID: 63044 (history)  
Form: Version .0  
Age: 6.0  
Sex: Male  
Location: New York  
Vaccinated:1994-05-03
Onset:1994-05-06
   Days after vaccination:3
Submitted: 1994-05-16
   Days after onset:10
Entered: 1994-05-23
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0178A / - GM / -

Administered by: Private       Purchased by: Private
Symptoms: Brain oedema, Conjunctivitis, Dehydration, Encephalopathy, Otitis media, Pyrexia, Vomiting
SMQs:, Severe cutaneous adverse reactions (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hyponatraemia/SIADH (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Conjunctival disorders (narrow), Ocular infections (broad), Chronic kidney disease (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1994-05-07
   Days after onset: 1
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: pvt
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy-brain specimens sent for viral studies;
CDC Split Type:

Write-up: 2 days following inject pt devel OM & conjunctivitis w/fever; treated w/Augmentin; devel vomiting & dehydration 3 days p/vax; unexputed death autopsy showed brain edema;


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20170214&IDNUMBER=63044


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