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This is VAERS ID 177594

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 177594
VAERS Form:
Age:1.0
Sex:Male
Location:California
Vaccinated:1997-07-23
Onset:1997-08-13
Submitted:2001-10-26
Entered:2001-11-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MSD 0104E / 0 RL / SC
VARCEL: VARICELLA (VARIVAX) / MSD 0345E / 0 LL / SC

Administered by: Private      Purchased by: Unknown
Symptoms: HYPOTONIA, MYASTHENIA, BONE DIS, AUTISM, APPETITE INC

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: Rash all over body;UNK. HEPATITIS B;3;.00;In Patient
Other Medications: Hydrocortisone 1% for eczema as needed
Current Illness: NONE
Preexisting Conditions: Mild atopic dermatitis
Allergies:
Diagnostic Lab Data: Heavy metal lab test, etc.
CDC 'Split Type': Mild atopic dermatitis

Write-up: 8/13/97, pt''s legs and feet gave way. He was bow-legged in lower legs and his feet turned in. Pt noted to have poor eye contact at 18 mos of age at which time milk addiction also started. 02/12/1999 pt had hypotonia throughout extremities and trunk. 7/1/9"9 pt was intoeing and had poor eye contact. 8/11/99 pt diagnosed as having autism with significant delay in speech.


Changed on 12/30/2006

VAERS ID: 177594 Before After
VAERS Form:
Age:1.0
Sex:Male
Location:California
Vaccinated:1997-07-23
Onset:1997-08-13
Submitted:2001-10-26
Entered:2001-11-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MSD 0104E / 0 RL / SC
VARCEL: VARICELLA (VARIVAX) / MSD 0345E / 0 LL / SC

Administered by: Private      Purchased by: Unknown
Symptoms: HYPOTONIA, MYASTHENIA, BONE DIS, AUTISM, APPETITE INC

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: Rash all over body;UNK. HEPATITIS B;3;.00;In Patient
Other Medications: Hydrocortisone 1% for eczema as needed
Current Illness: NONE
Preexisting Conditions: Mild atopic dermatitis
Allergies:
Diagnostic Lab Data: Heavy metal lab test, etc.
CDC 'Split Type': Mild atopic dermatitis

Write-up: 8/13/97, pt''s pt''''s legs and feet gave way. He was bow-legged in lower legs and his feet turned in. Pt noted to have poor eye contact at 18 mos of age at which time milk addiction also started. 02/12/1999 pt had hypotonia throughout extremities and trunk. 7/1/9"9 7/1/"99 pt was intoeing and had poor eye contact. 8/11/99 pt diagnosed as having autism with significant delay in speech.


Changed on 12/8/2009

VAERS ID: 177594 Before After
VAERS Form:
Age:1.0
Sex:Male
Location:California
Vaccinated:1997-07-23
Onset:1997-08-13
Submitted:2001-10-26
Entered:2001-11-14 2001-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 0104E / 0 RL / SC
VARCEL: VARICELLA (VARIVAX) VARICELLA (VARIVAX) / MSD MERCK & CO. INC. 0345E / 0 LL / SC

Administered by: Private      Purchased by: Unknown Other
Symptoms: Autism, Bone development abnormal, Hypotonia, Increased appetite, Muscular weakness, Speech disorder, Staring, HYPOTONIA, MYASTHENIA, BONE DIS, AUTISM, APPETITE INC

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: Rash all over body;UNK. HEPATITIS B;3;.00;In body;Hep B (unknown mfr);3;0;In Patient
Other Medications: Hydrocortisone 1% for eczema as needed
Current Illness: NONE
Preexisting Conditions: Mild atopic dermatitis
Allergies:
Diagnostic Lab Data: Heavy metal lab test, etc.
CDC 'Split Type': Mild atopic dermatitis (blank)

Write-up: 8/13/97, pt''''s pt''s legs and feet gave way. He was bow-legged in lower legs and his feet turned in. Pt noted to have poor eye contact at 18 mos of age at which time milk addiction also started. 02/12/1999 pt had hypotonia throughout extremities and trunk. 7/1/"99 7/1/99 pt was intoeing and had poor eye contact. 8/11/99 pt diagnosed as having autism with significant delay in speech.


Changed on 5/14/2017

VAERS ID: 177594 Before After
VAERS Form:
Age:1.0
Sex:Male
Location:California
Vaccinated:1997-07-23
Onset:1997-08-13
Submitted:2001-10-26
Entered:2001-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0104E / 0 RL / SC
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0345E / 0 LL / SC

Administered by: Private      Purchased by: Other
Symptoms: Autism, Bone development abnormal, Hypotonia, Increased appetite, Muscular weakness, Speech disorder, Staring

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: Rash all over body;Hep body~Hep B (unknown mfr);3;0;In (no brand name)~3~0.00~In Patient
Other Medications: Hydrocortisone 1% for eczema as needed
Current Illness: NONE
Preexisting Conditions: Mild atopic dermatitis
Allergies:
Diagnostic Lab Data: Heavy metal lab test, etc.
CDC 'Split Type':

Write-up: 8/13/97, pt''s legs and feet gave way. He was bow-legged in lower legs and his feet turned in. Pt noted to have poor eye contact at 18 mos of age at which time milk addiction also started. 02/12/1999 pt had hypotonia throughout extremities and trunk. 7/1/99 pt was intoeing and had poor eye contact. 8/11/99 pt diagnosed as having autism with significant delay in speech.


Changed on 9/14/2017

VAERS ID: 177594 Before After
VAERS Form:(blank) 1
Age:1.0
Sex:Male
Location:California
Vaccinated:1997-07-23
Onset:1997-08-13
Submitted:2001-10-26
Entered:2001-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0104E / 0 1 RL / SC
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0345E / 0 1 LL / SC

Administered by: Private      Purchased by: Other
Symptoms: Autism, Bone development abnormal, Hypotonia, Increased appetite, Muscular weakness, Speech disorder, Staring

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: Rash all over body~Hep B (no brand name)~3~0.00~In Patient
Other Medications: Hydrocortisone 1% for eczema as needed
Current Illness: NONE
Preexisting Conditions: Mild atopic dermatitis
Allergies:
Diagnostic Lab Data: Heavy metal lab test, etc.
CDC 'Split Type':

Write-up: 8/13/97, pt''s legs and feet gave way. He was bow-legged in lower legs and his feet turned in. Pt noted to have poor eye contact at 18 mos of age at which time milk addiction also started. 02/12/1999 pt had hypotonia throughout extremities and trunk. 7/1/99 pt was intoeing and had poor eye contact. 8/11/99 pt diagnosed as having autism with significant delay in speech.


Changed on 2/14/2018

VAERS ID: 177594 Before After
VAERS Form:1
Age:1.0
Sex:Male
Location:California
Vaccinated:1997-07-23
Onset:1997-08-13
Submitted:2001-10-26
Entered:2001-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0104E / 1 RL / SC
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0345E / 1 LL / SC

Administered by: Private      Purchased by: Other
Symptoms: Autism, Bone development abnormal, Hypotonia, Increased appetite, Muscular weakness, Speech disorder, Staring

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: Rash all over body~Hep B (no brand name)~3~0.00~In Patient
Other Medications: Hydrocortisone 1% for eczema as needed
Current Illness: NONE
Preexisting Conditions: Mild atopic dermatitis
Allergies:
Diagnostic Lab Data: Heavy metal lab test, etc.
CDC 'Split Type':

Write-up: 8/13/97, pt''s legs and feet gave way. He was bow-legged in lower legs and his feet turned in. Pt noted to have poor eye contact at 18 mos of age at which time milk addiction also started. 02/12/1999 pt had hypotonia throughout extremities and trunk. 7/1/99 pt was intoeing and had poor eye contact. 8/11/99 pt diagnosed as having autism with significant delay in speech.


Changed on 6/14/2018

VAERS ID: 177594 Before After
VAERS Form:1
Age:1.0
Sex:Male
Location:California
Vaccinated:1997-07-23
Onset:1997-08-13
Submitted:2001-10-26
Entered:2001-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0104E / 1 RL / SC
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0345E / 1 LL / SC

Administered by: Private      Purchased by: Other
Symptoms: Autism, Bone development abnormal, Hypotonia, Increased appetite, Muscular weakness, Speech disorder, Staring

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: Rash all over body~Hep B (no brand name)~3~0.00~In Patient
Other Medications: Hydrocortisone 1% for eczema as needed
Current Illness: NONE
Preexisting Conditions: Mild atopic dermatitis
Allergies:
Diagnostic Lab Data: Heavy metal lab test, etc.
CDC 'Split Type':

Write-up: 8/13/97, pt''s legs and feet gave way. He was bow-legged in lower legs and his feet turned in. Pt noted to have poor eye contact at 18 mos of age at which time milk addiction also started. 02/12/1999 pt had hypotonia throughout extremities and trunk. 7/1/99 pt was intoeing and had poor eye contact. 8/11/99 pt diagnosed as having autism with significant delay in speech.


Changed on 8/14/2018

VAERS ID: 177594 Before After
VAERS Form:1
Age:1.0
Sex:Male
Location:California
Vaccinated:1997-07-23
Onset:1997-08-13
Submitted:2001-10-26
Entered:2001-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0104E / 1 RL / SC
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0345E / 1 LL / SC

Administered by: Private      Purchased by: Other
Symptoms: Autism, Bone development abnormal, Hypotonia, Increased appetite, Muscular weakness, Speech disorder, Staring

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: Rash all over body~Hep B (no brand name)~3~0.00~In Patient
Other Medications: Hydrocortisone 1% for eczema as needed
Current Illness: NONE
Preexisting Conditions: Mild atopic dermatitis
Allergies:
Diagnostic Lab Data: Heavy metal lab test, etc.
CDC 'Split Type':

Write-up: 8/13/97, pt''s legs and feet gave way. He was bow-legged in lower legs and his feet turned in. Pt noted to have poor eye contact at 18 mos of age at which time milk addiction also started. 02/12/1999 pt had hypotonia throughout extremities and trunk. 7/1/99 pt was intoeing and had poor eye contact. 8/11/99 pt diagnosed as having autism with significant delay in speech.


Changed on 9/14/2018

VAERS ID: 177594 Before After
VAERS Form:1
Age:1.0
Sex:Male
Location:California
Vaccinated:1997-07-23
Onset:1997-08-13
Submitted:2001-10-26
Entered:2001-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0104E / 1 RL / SC
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0345E / 1 LL / SC

Administered by: Private      Purchased by: Other
Symptoms: Autism, Bone development abnormal, Hypotonia, Increased appetite, Muscular weakness, Speech disorder, Staring

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: Rash all over body~Hep B (no brand name)~3~0.00~In Patient
Other Medications: Hydrocortisone 1% for eczema as needed
Current Illness: NONE
Preexisting Conditions: Mild atopic dermatitis
Allergies:
Diagnostic Lab Data: Heavy metal lab test, etc.
CDC 'Split Type':

Write-up: 8/13/97, pt''s legs and feet gave way. He was bow-legged in lower legs and his feet turned in. Pt noted to have poor eye contact at 18 mos of age at which time milk addiction also started. 02/12/1999 pt had hypotonia throughout extremities and trunk. 7/1/99 pt was intoeing and had poor eye contact. 8/11/99 pt diagnosed as having autism with significant delay in speech.


Changed on 10/14/2018

VAERS ID: 177594 Before After
VAERS Form:1
Age:1.0
Sex:Male
Location:California
Vaccinated:1997-07-23
Onset:1997-08-13
Submitted:2001-10-26
Entered:2001-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0104E / 1 RL / SC
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0345E / 1 LL / SC

Administered by: Private      Purchased by: Other
Symptoms: Autism, Bone development abnormal, Hypotonia, Increased appetite, Muscular weakness, Speech disorder, Staring

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: Rash all over body~Hep B (no brand name)~3~0.00~In Patient
Other Medications: Hydrocortisone 1% for eczema as needed
Current Illness: NONE
Preexisting Conditions: Mild atopic dermatitis
Allergies:
Diagnostic Lab Data: Heavy metal lab test, etc.
CDC 'Split Type':

Write-up: 8/13/97, pt''s legs and feet gave way. He was bow-legged in lower legs and his feet turned in. Pt noted to have poor eye contact at 18 mos of age at which time milk addiction also started. 02/12/1999 pt had hypotonia throughout extremities and trunk. 7/1/99 pt was intoeing and had poor eye contact. 8/11/99 pt diagnosed as having autism with significant delay in speech.


Changed on 12/24/2020

VAERS ID: 177594 Before After
VAERS Form:1
Age:1.0
Sex:Male
Location:California
Vaccinated:1997-07-23
Onset:1997-08-13
Submitted:2001-10-26
Entered:2001-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0104E / 1 RL / SC
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0345E / 1 LL / SC

Administered by: Private      Purchased by: Other
Symptoms: Autism, Bone development abnormal, Hypotonia, Increased appetite, Muscular weakness, Speech disorder, Staring

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: Rash all over body~Hep B (no brand name)~3~0.00~In Patient
Other Medications: Hydrocortisone 1% for eczema as needed
Current Illness: NONE
Preexisting Conditions: Mild atopic dermatitis
Allergies:
Diagnostic Lab Data: Heavy metal lab test, etc.
CDC 'Split Type':

Write-up: 8/13/97, pt''s legs and feet gave way. He was bow-legged in lower legs and his feet turned in. Pt noted to have poor eye contact at 18 mos of age at which time milk addiction also started. 02/12/1999 pt had hypotonia throughout extremities and trunk. 7/1/99 pt was intoeing and had poor eye contact. 8/11/99 pt diagnosed as having autism with significant delay in speech.


Changed on 12/30/2020

VAERS ID: 177594 Before After
VAERS Form:1
Age:1.0
Sex:Male
Location:California
Vaccinated:1997-07-23
Onset:1997-08-13
Submitted:2001-10-26
Entered:2001-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0104E / 1 RL / SC
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0345E / 1 LL / SC

Administered by: Private      Purchased by: Other
Symptoms: Autism, Bone development abnormal, Hypotonia, Increased appetite, Muscular weakness, Speech disorder, Staring

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: Rash all over body~Hep B (no brand name)~3~0.00~In Patient
Other Medications: Hydrocortisone 1% for eczema as needed
Current Illness: NONE
Preexisting Conditions: Mild atopic dermatitis
Allergies:
Diagnostic Lab Data: Heavy metal lab test, etc.
CDC 'Split Type':

Write-up: 8/13/97, pt''s legs and feet gave way. He was bow-legged in lower legs and his feet turned in. Pt noted to have poor eye contact at 18 mos of age at which time milk addiction also started. 02/12/1999 pt had hypotonia throughout extremities and trunk. 7/1/99 pt was intoeing and had poor eye contact. 8/11/99 pt diagnosed as having autism with significant delay in speech.


Changed on 5/7/2021

VAERS ID: 177594 Before After
VAERS Form:1
Age:1.0
Sex:Male
Location:California
Vaccinated:1997-07-23
Onset:1997-08-13
Submitted:2001-10-26
Entered:2001-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0104E / 1 RL / SC
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0345E / 1 LL / SC

Administered by: Private      Purchased by: Other
Symptoms: Autism, Bone development abnormal, Hypotonia, Increased appetite, Muscular weakness, Speech disorder, Staring

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: Rash all over body~Hep B (no brand name)~3~0.00~In Patient
Other Medications: Hydrocortisone 1% for eczema as needed
Current Illness: NONE
Preexisting Conditions: Mild atopic dermatitis
Allergies:
Diagnostic Lab Data: Heavy metal lab test, etc.
CDC 'Split Type':

Write-up: 8/13/97, pt''s legs and feet gave way. He was bow-legged in lower legs and his feet turned in. Pt noted to have poor eye contact at 18 mos of age at which time milk addiction also started. 02/12/1999 pt had hypotonia throughout extremities and trunk. 7/1/99 pt was intoeing and had poor eye contact. 8/11/99 pt diagnosed as having autism with significant delay in speech.


Changed on 5/14/2021

VAERS ID: 177594 Before After
VAERS Form:1
Age:1.0
Sex:Male
Location:California
Vaccinated:1997-07-23
Onset:1997-08-13
Submitted:2001-10-26
Entered:2001-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0104E / 1 RL / SC
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0345E / 1 LL / SC

Administered by: Private      Purchased by: Other
Symptoms: Autism, Bone development abnormal, Hypotonia, Increased appetite, Muscular weakness, Speech disorder, Staring

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: Rash all over body~Hep B (no brand name)~3~0.00~In Patient
Other Medications: Hydrocortisone 1% for eczema as needed
Current Illness: NONE
Preexisting Conditions: Mild atopic dermatitis
Allergies:
Diagnostic Lab Data: Heavy metal lab test, etc.
CDC 'Split Type':

Write-up: 8/13/97, pt''s legs and feet gave way. He was bow-legged in lower legs and his feet turned in. Pt noted to have poor eye contact at 18 mos of age at which time milk addiction also started. 02/12/1999 pt had hypotonia throughout extremities and trunk. 7/1/99 pt was intoeing and had poor eye contact. 8/11/99 pt diagnosed as having autism with significant delay in speech.

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