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This is VAERS ID 92248

(NOTE: This result is from the 12/31/2003 version of the VAERS database)

Case Details

VAERS ID: 92248 (history)  
Form: Version .0  
Age: 1.2  
Sex: Male  
Location: New Jersey  
   Days after vaccination:1
Submitted: 1996-11-18
   Days after onset:10
Entered: 1996-11-25
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II / MSD 0469D / 0 A / SC

Administered by: Private       Purchased by: Unknown
Symptoms: SALIVA INC

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1996-11-08
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: sickle cell trait
Diagnostic Lab Data:
CDC Split Type: sickle cell trait

Write-up: found foaming @ the mouth;died suddenly-autopsy results not available;

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