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This is VAERS ID 837423

History of Changes from the VAERS Wayback Machine

First Appeared on 2/14/2020

VAERS ID: 837423
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 - / UNK - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Respiratory failure

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': CO0095075131910COL000726

Write-up: RESPIRATORY FAILURE; This spontaneous report was received from a regulatory authority and refers to a 2-year-old male patient. There was no information about the patient''s concurrent conditions, concomitant therapies or medical history provided. On an unknown date, the patient was vaccinated with dose of varicella virus vaccine live (oka/merck)(manufacturer unknown) product dose: 3 (units not provided)(dose number, route and site of administration, lot# and expiration date were not reported). On an unknown date, the patient experienced respiratory failure. Outcome of respiratory failure was reported as fatal. The causality assessment was not provided.

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