National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 112335

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 112335
VAERS Form:
Age:38.7
Sex:Male
Location:Hawaii
Vaccinated:1998-04-27
Onset:1998-05-04
Submitted:1998-06-25
Entered:1998-07-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARIVAX / MSD 0052H / 0 LA / SC

Administered by: Private      Purchased by: Unknown
Symptoms: APNEA, HEART ARREST, EDEMA BRAIN, CORONARY ART DIS, ARTERIOSCLEROSIS

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-05-04
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: hypercholesterolemia, sinusitis and asthma
Allergies:
Diagnostic Lab Data: 25APR98 immunoglobulin G index negative;
CDC 'Split Type':

Write-up: pt recv vax 27APR98 & 4MAY98 pt died;COD unk;the reporting MD noted that @ the time of vax pt appeared in good health;


Changed on 12/8/2009

VAERS ID: 112335 Before After
VAERS Form:
Age:38.7 38.0
Sex:Male
Location:Hawaii
Vaccinated:1998-04-27
Onset:1998-05-04
Submitted:1998-06-25
Entered:1998-07-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARIVAX VARICELLA (VARIVAX) / MSD MERCK & CO. INC. 0052H / 0 LA / SC

Administered by: Private Unknown      Purchased by: Unknown
Symptoms: Apnoea, Arteriosclerosis, Cardiac arrest, Coronary artery disease, Myocardial ischaemia, Brain oedema, APNEA, HEART ARREST, EDEMA BRAIN, CORONARY ART DIS, ARTERIOSCLEROSIS

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-05-04
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 NONE
Current Illness: NONE
Preexisting Conditions: hypercholesterolemia, sinusitis and asthma NONE
Allergies:
Diagnostic Lab Data: varicella IGG teston 25APR98 immunoglobulin G index was negative;
CDC 'Split Type':

Write-up: pt exposed to chickenpox 12wk prior to first visit;varicella IGG test was negative 25APR98;pt recv vax 27APR98 & no subsequent sx;pt was found lifeless on 4MAY98 pt died;COD unk;the reporting MD noted that @ the time of vax pt appeared in good health; while taking a nap;autopsy was performed;


Changed on 5/14/2017

VAERS ID: 112335 Before After
VAERS Form:
Age:38.0
Sex:Male
Location:Hawaii
Vaccinated:1998-04-27
Onset:1998-05-04
Submitted:1998-06-25
Entered:1998-07-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0052H / 0 LA / SC

Administered by: Unknown Private      Purchased by: Unknown Private
Symptoms: Apnoea, Arteriosclerosis, Cardiac arrest, Coronary artery disease, Myocardial ischaemia, Brain oedema

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-05-04
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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: varicella IGG teston 25APR98 was negative;
CDC 'Split Type':

Write-up: pt exposed to chickenpox 12wk prior to first visit;varicella IGG test was negative 25APR98;pt recv vax 27APR98 no subsequent sx;pt was found lifeless on 4MAY98 while taking a nap;autopsy was performed;


Changed on 9/14/2017

VAERS ID: 112335 Before After
VAERS Form:(blank) 1
Age:38.0
Sex:Male
Location:Hawaii
Vaccinated:1998-04-27
Onset:1998-05-04
Submitted:1998-06-25
Entered:1998-07-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0052H / 0 1 LA / SC

Administered by: Private      Purchased by: Private
Symptoms: Apnoea, Arteriosclerosis, Cardiac arrest, Coronary artery disease, Myocardial ischaemia, Brain oedema

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-05-04
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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: varicella IGG teston 25APR98 was negative;
CDC 'Split Type':

Write-up: pt exposed to chickenpox 12wk prior to first visit;varicella IGG test was negative 25APR98;pt recv vax 27APR98 no subsequent sx;pt was found lifeless on 4MAY98 while taking a nap;autopsy was performed;


Changed on 2/14/2018

VAERS ID: 112335 Before After
VAERS Form:1
Age:38.0
Sex:Male
Location:Hawaii
Vaccinated:1998-04-27
Onset:1998-05-04
Submitted:1998-06-25
Entered:1998-07-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0052H / 1 LA / SC

Administered by: Private      Purchased by: Private
Symptoms: Apnoea, Arteriosclerosis, Cardiac arrest, Coronary artery disease, Myocardial ischaemia, Brain oedema

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-05-04
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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: varicella IGG teston 25APR98 was negative;
CDC 'Split Type':

Write-up: pt exposed to chickenpox 12wk prior to first visit;varicella IGG test was negative 25APR98;pt recv vax 27APR98 no subsequent sx;pt was found lifeless on 4MAY98 while taking a nap;autopsy was performed;


Changed on 6/14/2018

VAERS ID: 112335 Before After
VAERS Form:1
Age:38.0
Sex:Male
Location:Hawaii
Vaccinated:1998-04-27
Onset:1998-05-04
Submitted:1998-06-25
Entered:1998-07-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0052H / 1 LA / SC

Administered by: Private      Purchased by: Private
Symptoms: Apnoea, Arteriosclerosis, Cardiac arrest, Coronary artery disease, Myocardial ischaemia, Brain oedema

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-05-04
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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: varicella IGG teston 25APR98 was negative;
CDC 'Split Type':

Write-up: pt exposed to chickenpox 12wk prior to first visit;varicella IGG test was negative 25APR98;pt recv vax 27APR98 no subsequent sx;pt was found lifeless on 4MAY98 while taking a nap;autopsy was performed;


Changed on 8/14/2018

VAERS ID: 112335 Before After
VAERS Form:1
Age:38.0
Sex:Male
Location:Hawaii
Vaccinated:1998-04-27
Onset:1998-05-04
Submitted:1998-06-25
Entered:1998-07-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0052H / 1 LA / SC

Administered by: Private      Purchased by: Private
Symptoms: Apnoea, Arteriosclerosis, Cardiac arrest, Coronary artery disease, Myocardial ischaemia, Brain oedema

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-05-04
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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: varicella IGG teston 25APR98 was negative;
CDC 'Split Type':

Write-up: pt exposed to chickenpox 12wk prior to first visit;varicella IGG test was negative 25APR98;pt recv vax 27APR98 no subsequent sx;pt was found lifeless on 4MAY98 while taking a nap;autopsy was performed;


Changed on 9/14/2018

VAERS ID: 112335 Before After
VAERS Form:1
Age:38.0
Sex:Male
Location:Hawaii
Vaccinated:1998-04-27
Onset:1998-05-04
Submitted:1998-06-25
Entered:1998-07-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0052H / 1 LA / SC

Administered by: Private      Purchased by: Private
Symptoms: Apnoea, Arteriosclerosis, Cardiac arrest, Coronary artery disease, Myocardial ischaemia, Brain oedema

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-05-04
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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: varicella IGG teston 25APR98 was negative;
CDC 'Split Type':

Write-up: pt exposed to chickenpox 12wk prior to first visit;varicella IGG test was negative 25APR98;pt recv vax 27APR98 no subsequent sx;pt was found lifeless on 4MAY98 while taking a nap;autopsy was performed;


Changed on 10/14/2018

VAERS ID: 112335 Before After
VAERS Form:1
Age:38.0
Sex:Male
Location:Hawaii
Vaccinated:1998-04-27
Onset:1998-05-04
Submitted:1998-06-25
Entered:1998-07-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0052H / 1 LA / SC

Administered by: Private      Purchased by: Private
Symptoms: Apnoea, Arteriosclerosis, Cardiac arrest, Coronary artery disease, Myocardial ischaemia, Brain oedema

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-05-04
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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: varicella IGG teston 25APR98 was negative;
CDC 'Split Type':

Write-up: pt exposed to chickenpox 12wk prior to first visit;varicella IGG test was negative 25APR98;pt recv vax 27APR98 no subsequent sx;pt was found lifeless on 4MAY98 while taking a nap;autopsy was performed;

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=112335&WAYBACKHISTORY=ON


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