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This is VAERS ID 76001

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 76001
VAERS Form:
Age:7.6
Sex:Male
Location:Virginia
Vaccinated:1995-06-16
Onset:1995-06-22
Submitted:1995-07-14
Entered:1995-07-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARIVAX / MSD 0397B / 0 RA / -

Administered by: Private      Purchased by: Unknown
Symptoms: FEVER, HYPERTONIA, RASH VESIC BULL, NERVOUSNESS, CYST

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: pt exp fever @ 2mos w/pertussis dose 1
Other Medications: Rynatan pediatric susp
Current Illness: NONE
Preexisting Conditions: hx of asthma w/inj; enlarged tonsils w/prior sleep apnea
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': hx of asthma w/inj; enlarged tonsils w/prior sleep apnea

Write-up: involuntary muscle contractions involving many muscle groups intermittently present following few days of restlessness p/inj & cont from day post inj to present time;


Changed on 12/8/2009

VAERS ID: 76001 Before After
VAERS Form:
Age:7.6
Sex:Male
Location:Virginia
Vaccinated:1995-06-16
Onset:1995-06-22
Submitted:1995-07-14
Entered:1995-07-25 1995-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARIVAX VARICELLA (VARIVAX) / MSD MERCK & CO. INC. 0397B / 0 RA / -

Administered by: Private      Purchased by: Unknown Private
Symptoms: Cyst, Dermatitis bullous, Hypertonia, Muscle twitching, Nervousness, Pyrexia, FEVER, HYPERTONIA, RASH VESIC BULL, NERVOUSNESS, CYST

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: pt exp fever @ 2mos w/pertussis dose 1
Other Medications: Rynatan pediatric susp
Current Illness: NONE
Preexisting Conditions: hx of asthma w/inj; enlarged tonsils w/prior sleep apnea
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': hx of asthma w/inj; enlarged tonsils w/prior sleep apnea (blank)

Write-up: involuntary muscle contractions involving many muscle groups intermittently present following few days of restlessness p/inj & cont from day post inj to present time;


Changed on 2/14/2017

VAERS ID: 76001 Before After
VAERS Form:
Age:7.6 7.0
Sex:Male
Location:Virginia
Vaccinated:1995-06-16
Onset:1995-06-22
Submitted:1995-07-14
Entered:1995-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0397B / 0 RA / -

Administered by: Private      Purchased by: Private
Symptoms: Cyst, Dermatitis bullous, Hypertonia, Muscle twitching, Nervousness, Pyrexia

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: pt exp fever @ 2mos w/pertussis dose 1
Other Medications: Rynatan pediatric susp
Current Illness: NONE
Preexisting Conditions: hx of asthma w/inj; enlarged tonsils w/prior sleep apnea
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: involuntary muscle contractions involving many muscle groups intermittently present following few days of restlessness p/inj & cont from day post inj to present time;


Changed on 5/14/2017

VAERS ID: 76001 Before After
VAERS Form:
Age:7.0
Sex:Male
Location:Virginia
Vaccinated:1995-06-16
Onset:1995-06-22
Submitted:1995-07-14
Entered:1995-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0397B / 0 RA / -

Administered by: Private      Purchased by: Private
Symptoms: Cyst, Dermatitis bullous, Hypertonia, Muscle twitching, Nervousness, Pyrexia

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: pt exp fever @ 2mos w/pertussis dose 1 1~ ()~~~In patient
Other Medications: Rynatan pediatric susp
Current Illness: NONE
Preexisting Conditions: hx of asthma w/inj; enlarged tonsils w/prior sleep apnea
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: involuntary muscle contractions involving many muscle groups intermittently present following few days of restlessness p/inj & cont from day post inj to present time;


Changed on 9/14/2017

VAERS ID: 76001 Before After
VAERS Form:(blank) 1
Age:7.0
Sex:Male
Location:Virginia
Vaccinated:1995-06-16
Onset:1995-06-22
Submitted:1995-07-14
Entered:1995-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0397B / 0 1 RA / -

Administered by: Private      Purchased by: Private
Symptoms: Cyst, Dermatitis bullous, Hypertonia, Muscle twitching, Nervousness, Pyrexia

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: pt exp fever @ 2mos w/pertussis dose 1~ ()~~~In patient
Other Medications: Rynatan pediatric susp
Current Illness: NONE
Preexisting Conditions: hx of asthma w/inj; enlarged tonsils w/prior sleep apnea
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: involuntary muscle contractions involving many muscle groups intermittently present following few days of restlessness p/inj & cont from day post inj to present time;


Changed on 2/14/2018

VAERS ID: 76001 Before After
VAERS Form:1
Age:7.0
Sex:Male
Location:Virginia
Vaccinated:1995-06-16
Onset:1995-06-22
Submitted:1995-07-14
Entered:1995-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0397B / 1 RA / -

Administered by: Private      Purchased by: Private
Symptoms: Cyst, Dermatitis bullous, Hypertonia, Muscle twitching, Nervousness, Pyrexia

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: pt exp fever @ 2mos w/pertussis dose 1~ ()~~~In patient
Other Medications: Rynatan pediatric susp
Current Illness: NONE
Preexisting Conditions: hx of asthma w/inj; enlarged tonsils w/prior sleep apnea
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: involuntary muscle contractions involving many muscle groups intermittently present following few days of restlessness p/inj & cont from day post inj to present time;


Changed on 6/14/2018

VAERS ID: 76001 Before After
VAERS Form:1
Age:7.0
Sex:Male
Location:Virginia
Vaccinated:1995-06-16
Onset:1995-06-22
Submitted:1995-07-14
Entered:1995-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0397B / 1 RA / -

Administered by: Private      Purchased by: Private
Symptoms: Cyst, Dermatitis bullous, Hypertonia, Muscle twitching, Nervousness, Pyrexia

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: pt exp fever @ 2mos w/pertussis dose 1~ ()~~~In patient
Other Medications: Rynatan pediatric susp
Current Illness: NONE
Preexisting Conditions: hx of asthma w/inj; enlarged tonsils w/prior sleep apnea
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: involuntary muscle contractions involving many muscle groups intermittently present following few days of restlessness p/inj & cont from day post inj to present time;


Changed on 8/14/2018

VAERS ID: 76001 Before After
VAERS Form:1
Age:7.0
Sex:Male
Location:Virginia
Vaccinated:1995-06-16
Onset:1995-06-22
Submitted:1995-07-14
Entered:1995-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0397B / 1 RA / -

Administered by: Private      Purchased by: Private
Symptoms: Cyst, Dermatitis bullous, Hypertonia, Muscle twitching, Nervousness, Pyrexia

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: pt exp fever @ 2mos w/pertussis dose 1~ ()~~~In patient
Other Medications: Rynatan pediatric susp
Current Illness: NONE
Preexisting Conditions: hx of asthma w/inj; enlarged tonsils w/prior sleep apnea
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: involuntary muscle contractions involving many muscle groups intermittently present following few days of restlessness p/inj & cont from day post inj to present time;


Changed on 9/14/2018

VAERS ID: 76001 Before After
VAERS Form:1
Age:7.0
Sex:Male
Location:Virginia
Vaccinated:1995-06-16
Onset:1995-06-22
Submitted:1995-07-14
Entered:1995-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0397B / 1 RA / -

Administered by: Private      Purchased by: Private
Symptoms: Cyst, Dermatitis bullous, Hypertonia, Muscle twitching, Nervousness, Pyrexia

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: pt exp fever @ 2mos w/pertussis dose 1~ ()~~~In patient
Other Medications: Rynatan pediatric susp
Current Illness: NONE
Preexisting Conditions: hx of asthma w/inj; enlarged tonsils w/prior sleep apnea
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: involuntary muscle contractions involving many muscle groups intermittently present following few days of restlessness p/inj & cont from day post inj to present time;


Changed on 10/14/2018

VAERS ID: 76001 Before After
VAERS Form:1
Age:7.0
Sex:Male
Location:Virginia
Vaccinated:1995-06-16
Onset:1995-06-22
Submitted:1995-07-14
Entered:1995-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0397B / 1 RA / -

Administered by: Private      Purchased by: Private
Symptoms: Cyst, Dermatitis bullous, Hypertonia, Muscle twitching, Nervousness, Pyrexia

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: pt exp fever @ 2mos w/pertussis dose 1~ ()~~~In patient
Other Medications: Rynatan pediatric susp
Current Illness: NONE
Preexisting Conditions: hx of asthma w/inj; enlarged tonsils w/prior sleep apnea
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: involuntary muscle contractions involving many muscle groups intermittently present following few days of restlessness p/inj & cont from day post inj to present time;


Changed on 12/24/2020

VAERS ID: 76001 Before After
VAERS Form:1
Age:7.0
Sex:Male
Location:Virginia
Vaccinated:1995-06-16
Onset:1995-06-22
Submitted:1995-07-14
Entered:1995-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0397B / 1 RA / -

Administered by: Private      Purchased by: Private
Symptoms: Cyst, Dermatitis bullous, Hypertonia, Muscle twitching, Nervousness, Pyrexia

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: pt exp fever @ 2mos w/pertussis dose 1~ ()~~~In patient
Other Medications: Rynatan pediatric susp
Current Illness: NONE
Preexisting Conditions: hx of asthma w/inj; enlarged tonsils w/prior sleep apnea
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: involuntary muscle contractions involving many muscle groups intermittently present following few days of restlessness p/inj & cont from day post inj to present time;


Changed on 12/30/2020

VAERS ID: 76001 Before After
VAERS Form:1
Age:7.0
Sex:Male
Location:Virginia
Vaccinated:1995-06-16
Onset:1995-06-22
Submitted:1995-07-14
Entered:1995-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0397B / 1 RA / -

Administered by: Private      Purchased by: Private
Symptoms: Cyst, Dermatitis bullous, Hypertonia, Muscle twitching, Nervousness, Pyrexia

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: pt exp fever @ 2mos w/pertussis dose 1~ ()~~~In patient
Other Medications: Rynatan pediatric susp
Current Illness: NONE
Preexisting Conditions: hx of asthma w/inj; enlarged tonsils w/prior sleep apnea
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: involuntary muscle contractions involving many muscle groups intermittently present following few days of restlessness p/inj & cont from day post inj to present time;


Changed on 5/7/2021

VAERS ID: 76001 Before After
VAERS Form:1
Age:7.0
Sex:Male
Location:Virginia
Vaccinated:1995-06-16
Onset:1995-06-22
Submitted:1995-07-14
Entered:1995-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0397B / 1 RA / -

Administered by: Private      Purchased by: Private
Symptoms: Cyst, Dermatitis bullous, Hypertonia, Muscle twitching, Nervousness, Pyrexia

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: pt exp fever @ 2mos w/pertussis dose 1~ ()~~~In patient
Other Medications: Rynatan pediatric susp
Current Illness: NONE
Preexisting Conditions: hx of asthma w/inj; enlarged tonsils w/prior sleep apnea
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: involuntary muscle contractions involving many muscle groups intermittently present following few days of restlessness p/inj & cont from day post inj to present time;


Changed on 5/14/2021

VAERS ID: 76001 Before After
VAERS Form:1
Age:7.0
Sex:Male
Location:Virginia
Vaccinated:1995-06-16
Onset:1995-06-22
Submitted:1995-07-14
Entered:1995-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0397B / 1 RA / -

Administered by: Private      Purchased by: Private
Symptoms: Cyst, Dermatitis bullous, Hypertonia, Muscle twitching, Nervousness, Pyrexia

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: pt exp fever @ 2mos w/pertussis dose 1~ ()~~~In patient
Other Medications: Rynatan pediatric susp
Current Illness: NONE
Preexisting Conditions: hx of asthma w/inj; enlarged tonsils w/prior sleep apnea
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: involuntary muscle contractions involving many muscle groups intermittently present following few days of restlessness p/inj & cont from day post inj to present time;

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=76001&WAYBACKHISTORY=ON


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