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This is VAERS ID 107852

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 107852
VAERS Form:
Age:1.7
Sex:Female
Location:Pennsylvania
Vaccinated:1997-02-19
Onset:1997-03-01
Submitted:1998-02-23
Entered:1998-03-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARIVAX / MSD - / 0 - / -

Administered by: Other      Purchased by: Unknown
Symptoms: HEART ARREST, EDEMA BRAIN, HYPOXIA, ARRHYTHMIA, FIBRO MYOCARD

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1997-03-01
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: No relevant data;
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': unk

Write-up: pt recv vax 24FEB97 & 1MAR97 pt died of a cardiac death;f/u was recv from MD:the autopsy showed myocardial fibrosis, so MD concluded the pt must have had a viral myocarditis;


Changed on 12/8/2009

VAERS ID: 107852 Before After
VAERS Form:
Age:1.7
Sex:Female
Location:Pennsylvania
Vaccinated:1997-02-19
Onset:1997-03-01
Submitted:1998-02-23
Entered:1998-03-02 1998-02-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARIVAX VARICELLA (VARIVAX) / MSD MERCK & CO. INC. - / 0 - / -

Administered by: Other Unknown      Purchased by: Unknown
Symptoms: Arrhythmia, Cardiac arrest, Hepatic function abnormal, Hypoxia, Infection, Myocardial fibrosis, Myocarditis, Brain oedema, HEART ARREST, EDEMA BRAIN, HYPOXIA, ARRHYTHMIA, FIBRO MYOCARD

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1997-03-01
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: No relevant data;
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': unk WAES98012678

Write-up: pt recv vax 24FEB97 & 1MAR97 pt died of a cardiac death;f/u was recv from MD:the autopsy showed myocardial fibrosis, so MD concluded the pt must have had a viral myocarditis;


Changed on 5/14/2017

VAERS ID: 107852 Before After
VAERS Form:
Age:1.7
Sex:Female
Location:Pennsylvania
Vaccinated:1997-02-19
Onset:1997-03-01
Submitted:1998-02-23
Entered:1998-02-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / 0 - / -

Administered by: Unknown Other      Purchased by: Unknown Other
Symptoms: Arrhythmia, Cardiac arrest, Hepatic function abnormal, Hypoxia, Infection, Myocardial fibrosis, Myocarditis, Brain oedema

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1997-03-01
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: unk
Current Illness:
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES98012678

Write-up: pt recv vax 24FEB97 & 1MAR97 pt died of a cardiac death;f/u was recv from MD:the autopsy showed myocardial fibrosis, so MD concluded the pt must have had a viral myocarditis;


Changed on 9/14/2017

VAERS ID: 107852 Before After
VAERS Form:(blank) 1
Age:1.7
Sex:Female
Location:Pennsylvania
Vaccinated:1997-02-19
Onset:1997-03-01
Submitted:1998-02-23
Entered:1998-02-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / 0 1 - / -

Administered by: Other      Purchased by: Other
Symptoms: Arrhythmia, Cardiac arrest, Hepatic function abnormal, Hypoxia, Infection, Myocardial fibrosis, Myocarditis, Brain oedema

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1997-03-01
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: unk
Current Illness:
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES98012678

Write-up: pt recv vax 24FEB97 & 1MAR97 pt died of a cardiac death;f/u was recv from MD:the autopsy showed myocardial fibrosis, so MD concluded the pt must have had a viral myocarditis;


Changed on 2/14/2018

VAERS ID: 107852 Before After
VAERS Form:1
Age:1.7
Sex:Female
Location:Pennsylvania
Vaccinated:1997-02-19
Onset:1997-03-01
Submitted:1998-02-23
Entered:1998-02-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / 1 - / -

Administered by: Other      Purchased by: Other
Symptoms: Arrhythmia, Cardiac arrest, Hepatic function abnormal, Hypoxia, Infection, Myocardial fibrosis, Myocarditis, Brain oedema

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1997-03-01
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: unk
Current Illness:
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES98012678

Write-up: pt recv vax 24FEB97 & 1MAR97 pt died of a cardiac death;f/u was recv from MD:the autopsy showed myocardial fibrosis, so MD concluded the pt must have had a viral myocarditis;


Changed on 6/14/2018

VAERS ID: 107852 Before After
VAERS Form:1
Age:1.7
Sex:Female
Location:Pennsylvania
Vaccinated:1997-02-19
Onset:1997-03-01
Submitted:1998-02-23
Entered:1998-02-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / 1 - / -

Administered by: Other      Purchased by: Other
Symptoms: Arrhythmia, Cardiac arrest, Hepatic function abnormal, Hypoxia, Infection, Myocardial fibrosis, Myocarditis, Brain oedema

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1997-03-01
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: unk
Current Illness:
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES98012678

Write-up: pt recv vax 24FEB97 & 1MAR97 pt died of a cardiac death;f/u was recv from MD:the autopsy showed myocardial fibrosis, so MD concluded the pt must have had a viral myocarditis;


Changed on 8/14/2018

VAERS ID: 107852 Before After
VAERS Form:1
Age:1.7
Sex:Female
Location:Pennsylvania
Vaccinated:1997-02-19
Onset:1997-03-01
Submitted:1998-02-23
Entered:1998-02-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / 1 - / -

Administered by: Other      Purchased by: Other
Symptoms: Arrhythmia, Cardiac arrest, Hepatic function abnormal, Hypoxia, Infection, Myocardial fibrosis, Myocarditis, Brain oedema

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1997-03-01
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: unk
Current Illness:
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES98012678

Write-up: pt recv vax 24FEB97 & 1MAR97 pt died of a cardiac death;f/u was recv from MD:the autopsy showed myocardial fibrosis, so MD concluded the pt must have had a viral myocarditis;


Changed on 9/14/2018

VAERS ID: 107852 Before After
VAERS Form:1
Age:1.7
Sex:Female
Location:Pennsylvania
Vaccinated:1997-02-19
Onset:1997-03-01
Submitted:1998-02-23
Entered:1998-02-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / 1 - / -

Administered by: Other      Purchased by: Other
Symptoms: Arrhythmia, Cardiac arrest, Hepatic function abnormal, Hypoxia, Infection, Myocardial fibrosis, Myocarditis, Brain oedema

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1997-03-01
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: unk
Current Illness:
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES98012678

Write-up: pt recv vax 24FEB97 & 1MAR97 pt died of a cardiac death;f/u was recv from MD:the autopsy showed myocardial fibrosis, so MD concluded the pt must have had a viral myocarditis;


Changed on 10/14/2018

VAERS ID: 107852 Before After
VAERS Form:1
Age:1.7
Sex:Female
Location:Pennsylvania
Vaccinated:1997-02-19
Onset:1997-03-01
Submitted:1998-02-23
Entered:1998-02-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / 1 - / -

Administered by: Other      Purchased by: Other
Symptoms: Arrhythmia, Cardiac arrest, Hepatic function abnormal, Hypoxia, Infection, Myocardial fibrosis, Myocarditis, Brain oedema

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1997-03-01
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: unk
Current Illness:
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES98012678

Write-up: pt recv vax 24FEB97 & 1MAR97 pt died of a cardiac death;f/u was recv from MD:the autopsy showed myocardial fibrosis, so MD concluded the pt must have had a viral myocarditis;

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=107852&WAYBACKHISTORY=ON


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