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This is VAERS ID 112990

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 112990
VAERS Form:
Age:1.1
Sex:Male
Location:Missouri
Vaccinated:1998-07-01
Onset:1998-07-11
Submitted:1998-07-15
Entered:1998-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARIVAX / MSD 1357D / 0 - / -

Administered by: Private      Purchased by: Unknown
Symptoms: AGITATION, FEVER, CYANOSIS, MENINGITIS, MALAISE

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-07-13
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 11JUL98 pt began running fever & vomited once;mom gave APAP & fever went down;12JUL98 pt was sick & fussy in morning;by noon, pt had hands & lips turning blue;went to ER:13JUL98 pt died of meningococcal meningitis;


Changed on 12/8/2009

VAERS ID: 112990 Before After
VAERS Form:
Age:1.1
Sex:Male
Location:Missouri
Vaccinated:1998-07-01
Onset:1998-07-11
Submitted:1998-07-15
Entered:1998-08-04 1998-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARIVAX VARICELLA (VARIVAX) / MSD MERCK & CO. INC. 1357D / 0 - / -

Administered by: Private      Purchased by: Unknown Public
Symptoms: Agitation, Cyanosis, Malaise, Meningitis, Pyrexia, Vomiting, AGITATION, FEVER, CYANOSIS, MENINGITIS, MALAISE

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-07-13
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) MO98039

Write-up: 11JUL98 pt began running fever & vomited once;mom gave APAP & fever went down;12JUL98 pt was sick & fussy in morning;by noon, pt had hands & lips turning blue;went to ER:13JUL98 pt died of meningococcal meningitis;


Changed on 5/14/2017

VAERS ID: 112990 Before After
VAERS Form:
Age:1.1
Sex:Male
Location:Missouri
Vaccinated:1998-07-01
Onset:1998-07-11
Submitted:1998-07-15
Entered:1998-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1357D / 0 - / -

Administered by: Private      Purchased by: Public
Symptoms: Agitation, Cyanosis, Malaise, Meningitis, Pyrexia, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-07-13
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': MO98039

Write-up: 11JUL98 pt began running fever & vomited once;mom gave APAP & fever went down;12JUL98 pt was sick & fussy in morning;by noon, pt had hands & lips turning blue;went to ER:13JUL98 pt died of meningococcal meningitis;


Changed on 9/14/2017

VAERS ID: 112990 Before After
VAERS Form:(blank) 1
Age:1.1
Sex:Male
Location:Missouri
Vaccinated:1998-07-01
Onset:1998-07-11
Submitted:1998-07-15
Entered:1998-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1357D / 0 1 - / -

Administered by: Private      Purchased by: Public
Symptoms: Agitation, Cyanosis, Malaise, Meningitis, Pyrexia, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-07-13
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': MO98039

Write-up: 11JUL98 pt began running fever & vomited once;mom gave APAP & fever went down;12JUL98 pt was sick & fussy in morning;by noon, pt had hands & lips turning blue;went to ER:13JUL98 pt died of meningococcal meningitis;


Changed on 2/14/2018

VAERS ID: 112990 Before After
VAERS Form:1
Age:1.1
Sex:Male
Location:Missouri
Vaccinated:1998-07-01
Onset:1998-07-11
Submitted:1998-07-15
Entered:1998-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1357D / 1 - / -

Administered by: Private      Purchased by: Public
Symptoms: Agitation, Cyanosis, Malaise, Meningitis, Pyrexia, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-07-13
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': MO98039

Write-up: 11JUL98 pt began running fever & vomited once;mom gave APAP & fever went down;12JUL98 pt was sick & fussy in morning;by noon, pt had hands & lips turning blue;went to ER:13JUL98 pt died of meningococcal meningitis;


Changed on 6/14/2018

VAERS ID: 112990 Before After
VAERS Form:1
Age:1.1
Sex:Male
Location:Missouri
Vaccinated:1998-07-01
Onset:1998-07-11
Submitted:1998-07-15
Entered:1998-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1357D / 1 - / -

Administered by: Private      Purchased by: Public
Symptoms: Agitation, Cyanosis, Malaise, Meningitis, Pyrexia, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-07-13
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': MO98039

Write-up: 11JUL98 pt began running fever & vomited once;mom gave APAP & fever went down;12JUL98 pt was sick & fussy in morning;by noon, pt had hands & lips turning blue;went to ER:13JUL98 pt died of meningococcal meningitis;


Changed on 8/14/2018

VAERS ID: 112990 Before After
VAERS Form:1
Age:1.1
Sex:Male
Location:Missouri
Vaccinated:1998-07-01
Onset:1998-07-11
Submitted:1998-07-15
Entered:1998-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1357D / 1 - / -

Administered by: Private      Purchased by: Public
Symptoms: Agitation, Cyanosis, Malaise, Meningitis, Pyrexia, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-07-13
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': MO98039

Write-up: 11JUL98 pt began running fever & vomited once;mom gave APAP & fever went down;12JUL98 pt was sick & fussy in morning;by noon, pt had hands & lips turning blue;went to ER:13JUL98 pt died of meningococcal meningitis;


Changed on 9/14/2018

VAERS ID: 112990 Before After
VAERS Form:1
Age:1.1
Sex:Male
Location:Missouri
Vaccinated:1998-07-01
Onset:1998-07-11
Submitted:1998-07-15
Entered:1998-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1357D / 1 - / -

Administered by: Private      Purchased by: Public
Symptoms: Agitation, Cyanosis, Malaise, Meningitis, Pyrexia, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-07-13
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': MO98039

Write-up: 11JUL98 pt began running fever & vomited once;mom gave APAP & fever went down;12JUL98 pt was sick & fussy in morning;by noon, pt had hands & lips turning blue;went to ER:13JUL98 pt died of meningococcal meningitis;


Changed on 10/14/2018

VAERS ID: 112990 Before After
VAERS Form:1
Age:1.1
Sex:Male
Location:Missouri
Vaccinated:1998-07-01
Onset:1998-07-11
Submitted:1998-07-15
Entered:1998-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1357D / 1 - / -

Administered by: Private      Purchased by: Public
Symptoms: Agitation, Cyanosis, Malaise, Meningitis, Pyrexia, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-07-13
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': MO98039

Write-up: 11JUL98 pt began running fever & vomited once;mom gave APAP & fever went down;12JUL98 pt was sick & fussy in morning;by noon, pt had hands & lips turning blue;went to ER:13JUL98 pt died of meningococcal meningitis;

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=112990&WAYBACKHISTORY=ON


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