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This is VAERS ID 86283

(NOTE: This result is from the 9/14/2017 version of the VAERS database)

Case Details

VAERS ID: 86283 (history)  
Form: Version 1.0  
Age: 6.0  
Sex: Male  
Location: New York  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 1996-05-20
Entered: 1996-05-23
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0178A / UNK - / -

Administered by: Other       Purchased by: Other
Symptoms: Unevaluable event
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES96050726

Write-up: pt recv vax & shortly afterward pt exp a rapidly deteriorating condition & was hosp;pt died;COD was not reported;


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20170914&IDNUMBER=86283


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