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This is VAERS ID 837418

History of Changes from the VAERS Wayback Machine

First Appeared on 2/14/2020

VAERS ID: 837418
VAERS Form:2
Age:
Sex:Male
Location:Foreign
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:2019-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 3 - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Septic shock

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CO0095075131910COL000531

Write-up: SEPTIC SHOCK; Information has been received from a regulatory authority and refers to a 2-year-old male patient. His medical history, concurrent conditions and concomitant medications were not provided. On an unknown date, the patient was vaccinated with the third dose of varicella virus vaccine live (oka/merck) (manufacturer unknown) (exact dose, route of administration, lot# and expiration date were not reported). On an unknown date, the patient developed septic shock. The outcome of septic shock was reported as fatal. Causality assessment was not provided.; Reported Cause(s) of Death: Septic shock

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