National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 106654

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 106654
VAERS Form:
Age:1.0
Sex:Male
Location:New York
Vaccinated:1998-01-05
Onset:1998-01-18
Submitted:1998-01-19
Entered:1998-01-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARIVAX / MSD 1160E / 0 - / -

Administered by: Private      Purchased by: Unknown
Symptoms: CONVULS, FEVER, DYSPNEA, ENCEPHALITIS, MALAISE

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1998-01-19
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: MD notified @ home from ER-parents heard pt gasp-pt having sz-pt taken to ER where died;


Changed on 12/8/2009

VAERS ID: 106654 Before After
VAERS Form:
Age:1.0
Sex:Male
Location:New York
Vaccinated:1998-01-05
Onset:1998-01-18
Submitted:1998-01-19
Entered:1998-01-21 1998-01-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARIVAX VARICELLA (VARIVAX) / MSD MERCK & CO. INC. 1160E / 0 - / -

Administered by: Private      Purchased by: Unknown Private
Symptoms: Convulsion, Dyspnoea, Encephalitis, Malaise, Pyrexia, Rash, CONVULS, FEVER, DYSPNEA, ENCEPHALITIS, MALAISE

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1998-01-19
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: MD notified @ home from ER-parents heard pt gasp-pt having sz-pt taken to ER where died;


Changed on 5/14/2017

VAERS ID: 106654 Before After
VAERS Form:
Age:1.0
Sex:Male
Location:New York
Vaccinated:1998-01-05
Onset:1998-01-18
Submitted:1998-01-19
Entered:1998-01-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1160E / 0 - / -

Administered by: Private      Purchased by: Private
Symptoms: Convulsion, Dyspnoea, Encephalitis, Malaise, Pyrexia, Rash

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1998-01-19
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: MD notified @ home from ER-parents heard pt gasp-pt having sz-pt taken to ER where died;


Changed on 9/14/2017

VAERS ID: 106654 Before After
VAERS Form:(blank) 1
Age:1.0
Sex:Male
Location:New York
Vaccinated:1998-01-05
Onset:1998-01-18
Submitted:1998-01-19
Entered:1998-01-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1160E / 0 1 - / -

Administered by: Private      Purchased by: Private
Symptoms: Convulsion, Dyspnoea, Encephalitis, Malaise, Pyrexia, Rash

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1998-01-19
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: MD notified @ home from ER-parents heard pt gasp-pt having sz-pt taken to ER where died;


Changed on 2/14/2018

VAERS ID: 106654 Before After
VAERS Form:1
Age:1.0
Sex:Male
Location:New York
Vaccinated:1998-01-05
Onset:1998-01-18
Submitted:1998-01-19
Entered:1998-01-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1160E / 1 - / -

Administered by: Private      Purchased by: Private
Symptoms: Convulsion, Dyspnoea, Encephalitis, Malaise, Pyrexia, Rash

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1998-01-19
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: MD notified @ home from ER-parents heard pt gasp-pt having sz-pt taken to ER where died;


Changed on 6/14/2018

VAERS ID: 106654 Before After
VAERS Form:1
Age:1.0
Sex:Male
Location:New York
Vaccinated:1998-01-05
Onset:1998-01-18
Submitted:1998-01-19
Entered:1998-01-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1160E / 1 - / -

Administered by: Private      Purchased by: Private
Symptoms: Convulsion, Dyspnoea, Encephalitis, Malaise, Pyrexia, Rash

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1998-01-19
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: MD notified @ home from ER-parents heard pt gasp-pt having sz-pt taken to ER where died;


Changed on 8/14/2018

VAERS ID: 106654 Before After
VAERS Form:1
Age:1.0
Sex:Male
Location:New York
Vaccinated:1998-01-05
Onset:1998-01-18
Submitted:1998-01-19
Entered:1998-01-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1160E / 1 - / -

Administered by: Private      Purchased by: Private
Symptoms: Convulsion, Dyspnoea, Encephalitis, Malaise, Pyrexia, Rash

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1998-01-19
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: MD notified @ home from ER-parents heard pt gasp-pt having sz-pt taken to ER where died;


Changed on 9/14/2018

VAERS ID: 106654 Before After
VAERS Form:1
Age:1.0
Sex:Male
Location:New York
Vaccinated:1998-01-05
Onset:1998-01-18
Submitted:1998-01-19
Entered:1998-01-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1160E / 1 - / -

Administered by: Private      Purchased by: Private
Symptoms: Convulsion, Dyspnoea, Encephalitis, Malaise, Pyrexia, Rash

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1998-01-19
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: MD notified @ home from ER-parents heard pt gasp-pt having sz-pt taken to ER where died;


Changed on 10/14/2018

VAERS ID: 106654 Before After
VAERS Form:1
Age:1.0
Sex:Male
Location:New York
Vaccinated:1998-01-05
Onset:1998-01-18
Submitted:1998-01-19
Entered:1998-01-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1160E / 1 - / -

Administered by: Private      Purchased by: Private
Symptoms: Convulsion, Dyspnoea, Encephalitis, Malaise, Pyrexia, Rash

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1998-01-19
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: MD notified @ home from ER-parents heard pt gasp-pt having sz-pt taken to ER where died;

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=106654&WAYBACKHISTORY=ON


Copyright © 2020 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166