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This is VAERS ID 108124

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 108124
VAERS Form:
Age:
Sex:Unknown
Location:New York
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1998-03-06
Entered:1998-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARIVAX / MSD - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: REACT UNEVAL

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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 & died from complication of varicella vax (date unk);


Changed on 12/8/2009

VAERS ID: 108124 Before After
VAERS Form:
Age:
Sex:Unknown
Location:New York
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1998-03-06
Entered:1998-03-12 1998-03-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARIVAX VARICELLA (VARIVAX) / MSD MERCK & CO. INC. - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Unevaluable event, REACT UNEVAL

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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 WAES98021840

Write-up: pt recv vax & died from complication of varicella vax (date unk);


Changed on 5/14/2017

VAERS ID: 108124 Before After
VAERS Form:
Age:
Sex:Unknown
Location:New York
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1998-03-06
Entered:1998-03-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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; data;~ ()~~~In patient
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES98021840

Write-up: pt recv vax & died from complication of varicella vax (date unk);


Changed on 9/14/2017

VAERS ID: 108124 Before After
VAERS Form:(blank) 1
Age:
Sex:Unknown
Location:New York
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1998-03-06
Entered:1998-03-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / - UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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;~ ()~~~In patient
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES98021840

Write-up: pt recv vax & died from complication of varicella vax (date unk);


Changed on 2/14/2018

VAERS ID: 108124 Before After
VAERS Form:1
Age:
Sex:Unknown
Location:New York
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1998-03-06
Entered:1998-03-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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;~ ()~~~In patient
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES98021840

Write-up: pt recv vax & died from complication of varicella vax (date unk);


Changed on 6/14/2018

VAERS ID: 108124 Before After
VAERS Form:1
Age:
Sex:Unknown
Location:New York
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1998-03-06
Entered:1998-03-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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;~ ()~~~In patient
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES98021840

Write-up: pt recv vax & died from complication of varicella vax (date unk);


Changed on 8/14/2018

VAERS ID: 108124 Before After
VAERS Form:1
Age:
Sex:Unknown
Location:New York
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1998-03-06
Entered:1998-03-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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;~ ()~~~In patient
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES98021840

Write-up: pt recv vax & died from complication of varicella vax (date unk);


Changed on 9/14/2018

VAERS ID: 108124 Before After
VAERS Form:1
Age:
Sex:Unknown
Location:New York
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1998-03-06
Entered:1998-03-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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;~ ()~~~In patient
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES98021840

Write-up: pt recv vax & died from complication of varicella vax (date unk);


Changed on 10/14/2018

VAERS ID: 108124 Before After
VAERS Form:1
Age:
Sex:Unknown
Location:New York
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1998-03-06
Entered:1998-03-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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;~ ()~~~In patient
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES98021840

Write-up: pt recv vax & died from complication of varicella vax (date unk);

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=108124&WAYBACKHISTORY=ON


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