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This is VAERS ID 113661

History of Changes from the VAERS Wayback Machine

First Appeared on 2/14/2017

VAERS ID: 113661
VAERS Form:
Age:1.3
Sex:Female
Location:Unknown
Vaccinated:1998-05-11
Onset:1998-05-16
Submitted:1998-08-24
Entered:1998-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 0 - / -
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cardiovascular disorder, Condition aggravated, Hepatitis, Hypersensitivity, Hypertonia, Meningitis, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-05-16
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: antimicrobial therapy
Current Illness:
Preexisting Conditions: otitis med;upper resp infect
Allergies:
Diagnostic Lab Data: autopsy eosinophils around cardiac vessles;autopsy no viral inclusions in liver;only frontal lobe specimen pos for wild type VZV on PCR analysis;heart & cerebellum high ELISA''s
CDC 'Split Type': WAES98070287

Write-up: 4 days post vax pt died;mom described child as fussy 15MAY98 w/n/v then becoming rigid in arms & legs;COD originally believe to be myocarditis now feel meningitis;sz, noted hepatitis w/multifocal inflam;allerg react;


Changed on 9/14/2017

VAERS ID: 113661 Before After
VAERS Form:(blank) 1
Age:1.3
Sex:Female
Location:Unknown
Vaccinated:1998-05-11
Onset:1998-05-16
Submitted:1998-08-24
Entered:1998-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 0 1 - / -
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / - UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cardiovascular disorder, Condition aggravated, Hepatitis, Hypersensitivity, Hypertonia, Meningitis, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-05-16
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: antimicrobial therapy
Current Illness:
Preexisting Conditions: otitis med;upper resp infect
Allergies:
Diagnostic Lab Data: autopsy eosinophils around cardiac vessles;autopsy no viral inclusions in liver;only frontal lobe specimen pos for wild type VZV on PCR analysis;heart & cerebellum high ELISA''s
CDC 'Split Type': WAES98070287

Write-up: 4 days post vax pt died;mom described child as fussy 15MAY98 w/n/v then becoming rigid in arms & legs;COD originally believe to be myocarditis now feel meningitis;sz, noted hepatitis w/multifocal inflam;allerg react;


Changed on 2/14/2018

VAERS ID: 113661 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Unknown
Vaccinated:1998-05-11
Onset:1998-05-16
Submitted:1998-08-24
Entered:1998-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cardiovascular disorder, Condition aggravated, Hepatitis, Hypersensitivity, Hypertonia, Meningitis, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-05-16
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: antimicrobial therapy
Current Illness:
Preexisting Conditions: otitis med;upper resp infect
Allergies:
Diagnostic Lab Data: autopsy eosinophils around cardiac vessles;autopsy no viral inclusions in liver;only frontal lobe specimen pos for wild type VZV on PCR analysis;heart & cerebellum high ELISA''s
CDC 'Split Type': WAES98070287

Write-up: 4 days post vax pt died;mom described child as fussy 15MAY98 w/n/v then becoming rigid in arms & legs;COD originally believe to be myocarditis now feel meningitis;sz, noted hepatitis w/multifocal inflam;allerg react;


Changed on 6/14/2018

VAERS ID: 113661 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Unknown
Vaccinated:1998-05-11
Onset:1998-05-16
Submitted:1998-08-24
Entered:1998-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cardiovascular disorder, Condition aggravated, Hepatitis, Hypersensitivity, Hypertonia, Meningitis, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-05-16
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: antimicrobial therapy
Current Illness:
Preexisting Conditions: otitis med;upper resp infect
Allergies:
Diagnostic Lab Data: autopsy eosinophils around cardiac vessles;autopsy no viral inclusions in liver;only frontal lobe specimen pos for wild type VZV on PCR analysis;heart & cerebellum high ELISA''s
CDC 'Split Type': WAES98070287

Write-up: 4 days post vax pt died;mom described child as fussy 15MAY98 w/n/v then becoming rigid in arms & legs;COD originally believe to be myocarditis now feel meningitis;sz, noted hepatitis w/multifocal inflam;allerg react;


Changed on 8/14/2018

VAERS ID: 113661 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Unknown
Vaccinated:1998-05-11
Onset:1998-05-16
Submitted:1998-08-24
Entered:1998-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cardiovascular disorder, Condition aggravated, Hepatitis, Hypersensitivity, Hypertonia, Meningitis, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-05-16
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: antimicrobial therapy
Current Illness:
Preexisting Conditions: otitis med;upper resp infect
Allergies:
Diagnostic Lab Data: autopsy eosinophils around cardiac vessles;autopsy no viral inclusions in liver;only frontal lobe specimen pos for wild type VZV on PCR analysis;heart & cerebellum high ELISA''s
CDC 'Split Type': WAES98070287

Write-up: 4 days post vax pt died;mom described child as fussy 15MAY98 w/n/v then becoming rigid in arms & legs;COD originally believe to be myocarditis now feel meningitis;sz, noted hepatitis w/multifocal inflam;allerg react;


Changed on 9/14/2018

VAERS ID: 113661 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Unknown
Vaccinated:1998-05-11
Onset:1998-05-16
Submitted:1998-08-24
Entered:1998-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cardiovascular disorder, Condition aggravated, Hepatitis, Hypersensitivity, Hypertonia, Meningitis, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-05-16
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: antimicrobial therapy
Current Illness:
Preexisting Conditions: otitis med;upper resp infect
Allergies:
Diagnostic Lab Data: autopsy eosinophils around cardiac vessles;autopsy no viral inclusions in liver;only frontal lobe specimen pos for wild type VZV on PCR analysis;heart & cerebellum high ELISA''s
CDC 'Split Type': WAES98070287

Write-up: 4 days post vax pt died;mom described child as fussy 15MAY98 w/n/v then becoming rigid in arms & legs;COD originally believe to be myocarditis now feel meningitis;sz, noted hepatitis w/multifocal inflam;allerg react;


Changed on 10/14/2018

VAERS ID: 113661 Before After
VAERS Form:1
Age:1.3
Sex:Female
Location:Unknown
Vaccinated:1998-05-11
Onset:1998-05-16
Submitted:1998-08-24
Entered:1998-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cardiovascular disorder, Condition aggravated, Hepatitis, Hypersensitivity, Hypertonia, Meningitis, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1998-05-16
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: antimicrobial therapy
Current Illness:
Preexisting Conditions: otitis med;upper resp infect
Allergies:
Diagnostic Lab Data: autopsy eosinophils around cardiac vessles;autopsy no viral inclusions in liver;only frontal lobe specimen pos for wild type VZV on PCR analysis;heart & cerebellum high ELISA''s
CDC 'Split Type': WAES98070287

Write-up: 4 days post vax pt died;mom described child as fussy 15MAY98 w/n/v then becoming rigid in arms & legs;COD originally believe to be myocarditis now feel meningitis;sz, noted hepatitis w/multifocal inflam;allerg react;

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=113661&WAYBACKHISTORY=ON


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