National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 83782

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 83782
VAERS Form:
Age:1.7
Sex:Male
Location:Rhode Island
Vaccinated:1995-07-28
Onset:1995-08-04
Submitted:1996-03-17
Entered:1996-03-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARIVAX / MSD 1508B / 0 - / -

Administered by: Private      Purchased by: Unknown
Symptoms: EYES GAZE UPWARD, INJURY ACCID, HYPERTONIA, ATAXIA, CRY ABNORMAL

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Birth Defect; pt born with one of his kidneys 100% non-functional
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: whimpering, hands to head & screaming, eyes roll back & glazed;falling down @ times robotic movements, sensitive to light; duration of sx varied from 1 min. to 1 hr.;


Changed on 12/8/2009

VAERS ID: 83782 Before After
VAERS Form:
Age:1.7
Sex:Male
Location:Rhode Island
Vaccinated:1995-07-28
Onset:1995-08-04
Submitted:1996-03-17
Entered:1996-03-22 1996-03-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARIVAX VARICELLA (VARIVAX) / MSD MERCK & CO. INC. 1508B / 0 - / -

Administered by: Private      Purchased by: Unknown Private
Symptoms: Coordination abnormal, Crying, Hypertonia, Injury, Pain, Photophobia, Stupor, Gaze palsy, EYES GAZE UPWARD, INJURY ACCID, HYPERTONIA, ATAXIA, CRY ABNORMAL

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Birth Defect; pt born with one of his kidneys 100% non-functional
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: whimpering, hands to head & screaming, eyes roll back & glazed;falling down @ times robotic movements, sensitive to light; duration of sx varied from 1 min. to 1 hr.;


Changed on 5/14/2017

VAERS ID: 83782 Before After
VAERS Form:
Age:1.7
Sex:Male
Location:Rhode Island
Vaccinated:1995-07-28
Onset:1995-08-04
Submitted:1996-03-17
Entered:1996-03-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1508B / 0 - / -

Administered by: Private      Purchased by: Private
Symptoms: Coordination abnormal, Crying, Hypertonia, Injury, Pain, Photophobia, Stupor, Gaze palsy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Birth Defect; pt born with one of his kidneys 100% non-functional
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: whimpering, hands to head & screaming, eyes roll back & glazed;falling down @ times robotic movements, sensitive to light; duration of sx varied from 1 min. to 1 hr.;


Changed on 9/14/2017

VAERS ID: 83782 Before After
VAERS Form:(blank) 1
Age:1.7
Sex:Male
Location:Rhode Island
Vaccinated:1995-07-28
Onset:1995-08-04
Submitted:1996-03-17
Entered:1996-03-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1508B / 0 1 - / -

Administered by: Private      Purchased by: Private
Symptoms: Coordination abnormal, Crying, Hypertonia, Injury, Pain, Photophobia, Stupor, Gaze palsy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Birth Defect; pt born with one of his kidneys 100% non-functional
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: whimpering, hands to head & screaming, eyes roll back & glazed;falling down @ times robotic movements, sensitive to light; duration of sx varied from 1 min. to 1 hr.;


Changed on 2/14/2018

VAERS ID: 83782 Before After
VAERS Form:1
Age:1.7
Sex:Male
Location:Rhode Island
Vaccinated:1995-07-28
Onset:1995-08-04
Submitted:1996-03-17
Entered:1996-03-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1508B / 1 - / -

Administered by: Private      Purchased by: Private
Symptoms: Coordination abnormal, Crying, Hypertonia, Injury, Pain, Photophobia, Stupor, Gaze palsy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Birth Defect; pt born with one of his kidneys 100% non-functional
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: whimpering, hands to head & screaming, eyes roll back & glazed;falling down @ times robotic movements, sensitive to light; duration of sx varied from 1 min. to 1 hr.;


Changed on 6/14/2018

VAERS ID: 83782 Before After
VAERS Form:1
Age:1.7
Sex:Male
Location:Rhode Island
Vaccinated:1995-07-28
Onset:1995-08-04
Submitted:1996-03-17
Entered:1996-03-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1508B / 1 - / -

Administered by: Private      Purchased by: Private
Symptoms: Coordination abnormal, Crying, Hypertonia, Injury, Pain, Photophobia, Stupor, Gaze palsy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Birth Defect; pt born with one of his kidneys 100% non-functional
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: whimpering, hands to head & screaming, eyes roll back & glazed;falling down @ times robotic movements, sensitive to light; duration of sx varied from 1 min. to 1 hr.;


Changed on 8/14/2018

VAERS ID: 83782 Before After
VAERS Form:1
Age:1.7
Sex:Male
Location:Rhode Island
Vaccinated:1995-07-28
Onset:1995-08-04
Submitted:1996-03-17
Entered:1996-03-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1508B / 1 - / -

Administered by: Private      Purchased by: Private
Symptoms: Coordination abnormal, Crying, Hypertonia, Injury, Pain, Photophobia, Stupor, Gaze palsy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Birth Defect; pt born with one of his kidneys 100% non-functional
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: whimpering, hands to head & screaming, eyes roll back & glazed;falling down @ times robotic movements, sensitive to light; duration of sx varied from 1 min. to 1 hr.;


Changed on 9/14/2018

VAERS ID: 83782 Before After
VAERS Form:1
Age:1.7
Sex:Male
Location:Rhode Island
Vaccinated:1995-07-28
Onset:1995-08-04
Submitted:1996-03-17
Entered:1996-03-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1508B / 1 - / -

Administered by: Private      Purchased by: Private
Symptoms: Coordination abnormal, Crying, Hypertonia, Injury, Pain, Photophobia, Stupor, Gaze palsy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Birth Defect; pt born with one of his kidneys 100% non-functional
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: whimpering, hands to head & screaming, eyes roll back & glazed;falling down @ times robotic movements, sensitive to light; duration of sx varied from 1 min. to 1 hr.;


Changed on 10/14/2018

VAERS ID: 83782 Before After
VAERS Form:1
Age:1.7
Sex:Male
Location:Rhode Island
Vaccinated:1995-07-28
Onset:1995-08-04
Submitted:1996-03-17
Entered:1996-03-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1508B / 1 - / -

Administered by: Private      Purchased by: Private
Symptoms: Coordination abnormal, Crying, Hypertonia, Injury, Pain, Photophobia, Stupor, Gaze palsy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Birth Defect; pt born with one of his kidneys 100% non-functional
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: whimpering, hands to head & screaming, eyes roll back & glazed;falling down @ times robotic movements, sensitive to light; duration of sx varied from 1 min. to 1 hr.;


Changed on 12/24/2020

VAERS ID: 83782 Before After
VAERS Form:1
Age:1.7
Sex:Male
Location:Rhode Island
Vaccinated:1995-07-28
Onset:1995-08-04
Submitted:1996-03-17
Entered:1996-03-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1508B / 1 - / -

Administered by: Private      Purchased by: Private
Symptoms: Coordination abnormal, Crying, Hypertonia, Injury, Pain, Photophobia, Stupor, Gaze palsy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Birth Defect; pt born with one of his kidneys 100% non-functional
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: whimpering, hands to head & screaming, eyes roll back & glazed;falling down @ times robotic movements, sensitive to light; duration of sx varied from 1 min. to 1 hr.;


Changed on 12/30/2020

VAERS ID: 83782 Before After
VAERS Form:1
Age:1.7
Sex:Male
Location:Rhode Island
Vaccinated:1995-07-28
Onset:1995-08-04
Submitted:1996-03-17
Entered:1996-03-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1508B / 1 - / -

Administered by: Private      Purchased by: Private
Symptoms: Coordination abnormal, Crying, Hypertonia, Injury, Pain, Photophobia, Stupor, Gaze palsy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Birth Defect; pt born with one of his kidneys 100% non-functional
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: whimpering, hands to head & screaming, eyes roll back & glazed;falling down @ times robotic movements, sensitive to light; duration of sx varied from 1 min. to 1 hr.;


Changed on 5/7/2021

VAERS ID: 83782 Before After
VAERS Form:1
Age:1.7
Sex:Male
Location:Rhode Island
Vaccinated:1995-07-28
Onset:1995-08-04
Submitted:1996-03-17
Entered:1996-03-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1508B / 1 - / -

Administered by: Private      Purchased by: Private
Symptoms: Coordination abnormal, Crying, Hypertonia, Injury, Pain, Photophobia, Stupor, Gaze palsy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Birth Defect; pt born with one of his kidneys 100% non-functional
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: whimpering, hands to head & screaming, eyes roll back & glazed;falling down @ times robotic movements, sensitive to light; duration of sx varied from 1 min. to 1 hr.;


Changed on 5/14/2021

VAERS ID: 83782 Before After
VAERS Form:1
Age:1.7
Sex:Male
Location:Rhode Island
Vaccinated:1995-07-28
Onset:1995-08-04
Submitted:1996-03-17
Entered:1996-03-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1508B / 1 - / -

Administered by: Private      Purchased by: Private
Symptoms: Coordination abnormal, Crying, Hypertonia, Injury, Pain, Photophobia, Stupor, Gaze palsy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Birth Defect; pt born with one of his kidneys 100% non-functional
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: whimpering, hands to head & screaming, eyes roll back & glazed;falling down @ times robotic movements, sensitive to light; duration of sx varied from 1 min. to 1 hr.;

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=83782&WAYBACKHISTORY=ON


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166