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This is VAERS ID 857879

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History of Changes from the VAERS Wayback Machine

First Appeared on 2/14/2020

VAERS ID: 857879
VAERS Form:2
Age:45.0
Sex:Male
Location:New York
Vaccinated:2020-01-23
Onset:2020-01-24
Submitted:0000-00-00
Entered:2020-01-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. UNKNOWN / UNK - / UN

Administered by: Unknown      Purchased by: ??
Symptoms: Seizure

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2020-01-26
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: uncertain
Current Illness: rheumatoid arthritis
Preexisting Conditions: rheumatoid arthritis. alcohol abuse.
Allergies: nkda
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: seizure within 24 hours of vaccination


Changed on 12/24/2020

VAERS ID: 857879 Before After
VAERS Form:2
Age:45.0
Sex:Male
Location:New York
Vaccinated:2020-01-23
Onset:2020-01-24
Submitted:0000-00-00
Entered:2020-01-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. UNKNOWN / UNK - / UN

Administered by: Unknown      Purchased by: ??
Symptoms: Seizure

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2020-01-26
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: uncertain
Current Illness: rheumatoid arthritis
Preexisting Conditions: rheumatoid arthritis. alcohol abuse.
Allergies: nkda nkda
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: seizure within 24 hours of vaccination


Changed on 12/30/2020

VAERS ID: 857879 Before After
VAERS Form:2
Age:45.0
Sex:Male
Location:New York
Vaccinated:2020-01-23
Onset:2020-01-24
Submitted:0000-00-00
Entered:2020-01-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. UNKNOWN / UNK - / UN

Administered by: Unknown      Purchased by: ??
Symptoms: Seizure

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2020-01-26
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: uncertain
Current Illness: rheumatoid arthritis
Preexisting Conditions: rheumatoid arthritis. alcohol abuse.
Allergies: nkda nkda
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: seizure within 24 hours of vaccination


Changed on 5/7/2021

VAERS ID: 857879 Before After
VAERS Form:2
Age:45.0
Sex:Male
Location:New York
Vaccinated:2020-01-23
Onset:2020-01-24
Submitted:0000-00-00
Entered:2020-01-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. UNKNOWN / UNK - / UN

Administered by: Unknown      Purchased by: ??
Symptoms: Seizure

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2020-01-26
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: uncertain
Current Illness: rheumatoid arthritis
Preexisting Conditions: rheumatoid arthritis. alcohol abuse.
Allergies: nkda nkda
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: seizure within 24 hours of vaccination


Changed on 5/14/2021

VAERS ID: 857879 Before After
VAERS Form:2
Age:45.0
Sex:Male
Location:New York
Vaccinated:2020-01-23
Onset:2020-01-24
Submitted:0000-00-00
Entered:2020-01-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. UNKNOWN / UNK - / UN

Administered by: Unknown      Purchased by: ??
Symptoms: Seizure

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2020-01-26
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: uncertain
Current Illness: rheumatoid arthritis
Preexisting Conditions: rheumatoid arthritis. alcohol abuse.
Allergies: nkda nkda
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: seizure within 24 hours of vaccination

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