National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 106939

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 106939
VAERS Form:
Age:0.8
Sex:Unknown
Location:Missouri
Vaccinated:1968-02-02
Onset:1968-02-03
Submitted:0000-00-00
Entered:1998-01-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: UNK. DTP / UNCLASSIFIED - / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: AGITATION, CONVULS, APNEA, COMA, EDEMA BRAIN

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1968-02-03
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: NONE
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NONE

Write-up: day of vax pt was cranky & acted ill;next day 24hr later went unconscious for 8hr;pt brain swelled;pt died;


Changed on 12/8/2009

VAERS ID: 106939 Before After
VAERS Form:
Age:0.8
Sex:Unknown
Location:Missouri
Vaccinated:1968-02-02
Onset:1968-02-03
Submitted:0000-00-00
Entered:1998-01-27 1998-01-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: UNK. DTP DTP (NO BRAND NAME) / UNCLASSIFIED UNKNOWN MANUFACTURER - / - - / -

Administered by: Private Unknown      Purchased by: Unknown
Symptoms: Agitation, Apnoea, Coma, Convulsion, Malaise, Brain oedema, AGITATION, CONVULS, APNEA, COMA, EDEMA BRAIN

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1968-02-03
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: NONE
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NONE (blank)

Write-up: day of vax pt was cranky & acted ill;next day 24hr later went unconscious for 8hr;pt brain swelled;pt died;


Changed on 5/14/2017

VAERS ID: 106939 Before After
VAERS Form:
Age:0.8
Sex:Unknown
Location:Missouri
Vaccinated:1968-02-02
Onset:1968-02-03
Submitted:0000-00-00
Entered:1998-01-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Unknown Private      Purchased by: Unknown Private
Symptoms: Agitation, Apnoea, Coma, Convulsion, Malaise, Brain oedema

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1968-02-03
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: day of vax pt was cranky & acted ill;next day 24hr later went unconscious for 8hr;pt brain swelled;pt died;


Changed on 9/14/2017

VAERS ID: 106939 Before After
VAERS Form:(blank) 1
Age:0.8
Sex:Unknown
Location:Missouri
Vaccinated:1968-02-02
Onset:1968-02-03
Submitted:0000-00-00
Entered:1998-01-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Agitation, Apnoea, Coma, Convulsion, Malaise, Brain oedema

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1968-02-03
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: day of vax pt was cranky & acted ill;next day 24hr later went unconscious for 8hr;pt brain swelled;pt died;


Changed on 2/14/2018

VAERS ID: 106939 Before After
VAERS Form:1
Age:0.8
Sex:Unknown
Location:Missouri
Vaccinated:1968-02-02
Onset:1968-02-03
Submitted:0000-00-00
Entered:1998-01-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Agitation, Apnoea, Coma, Convulsion, Malaise, Brain oedema

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1968-02-03
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: day of vax pt was cranky & acted ill;next day 24hr later went unconscious for 8hr;pt brain swelled;pt died;


Changed on 6/14/2018

VAERS ID: 106939 Before After
VAERS Form:1
Age:0.8
Sex:Unknown
Location:Missouri
Vaccinated:1968-02-02
Onset:1968-02-03
Submitted:0000-00-00
Entered:1998-01-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Agitation, Apnoea, Coma, Convulsion, Malaise, Brain oedema

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1968-02-03
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: day of vax pt was cranky & acted ill;next day 24hr later went unconscious for 8hr;pt brain swelled;pt died;


Changed on 8/14/2018

VAERS ID: 106939 Before After
VAERS Form:1
Age:0.8
Sex:Unknown
Location:Missouri
Vaccinated:1968-02-02
Onset:1968-02-03
Submitted:0000-00-00
Entered:1998-01-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Agitation, Apnoea, Coma, Convulsion, Malaise, Brain oedema

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1968-02-03
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: day of vax pt was cranky & acted ill;next day 24hr later went unconscious for 8hr;pt brain swelled;pt died;


Changed on 9/14/2018

VAERS ID: 106939 Before After
VAERS Form:1
Age:0.8
Sex:Unknown
Location:Missouri
Vaccinated:1968-02-02
Onset:1968-02-03
Submitted:0000-00-00
Entered:1998-01-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Agitation, Apnoea, Coma, Convulsion, Malaise, Brain oedema

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1968-02-03
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: day of vax pt was cranky & acted ill;next day 24hr later went unconscious for 8hr;pt brain swelled;pt died;


Changed on 10/14/2018

VAERS ID: 106939 Before After
VAERS Form:1
Age:0.8
Sex:Unknown
Location:Missouri
Vaccinated:1968-02-02
Onset:1968-02-03
Submitted:0000-00-00
Entered:1998-01-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Agitation, Apnoea, Coma, Convulsion, Malaise, Brain oedema

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1968-02-03
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: day of vax pt was cranky & acted ill;next day 24hr later went unconscious for 8hr;pt brain swelled;pt died;

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=106939&WAYBACKHISTORY=ON


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