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From the 10/8/2021 release of VAERS data:

Found 3,102 cases where Patient Died and Vaccination Date from '2007-08-01' to '2020-11-30'



Case Details

This is page 1 out of 311

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VAERS ID: 287915 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Male  
Location: Iowa  
Vaccinated:2007-08-02
Onset:2007-08-06
   Days after vaccination:4
Submitted: 2007-08-13
   Days after onset:7
Entered: 2007-08-14
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B079BA / 1 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF117AA / 1 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B20510B / 1 RL / IM

Administered by: Private       Purchased by: Public
Symptoms: Autopsy, Sudden infant death syndrome
SMQs:, Neonatal disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2007-08-06
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Preterm Birth HX: mother required 1 mo hospitalization prior to birth & had uterine rupture during delivery. Seen on weekly basis by pcp & HH nurse. Had no signs of illness prior to death.
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient died 8/6/07 presumed SIDS, autopsy pending. 8/23/07 Received prelim autopsy report from coroner. COD is pending. Patient was 34 wk preemie twin. Mother had been hospitalized x 1 mo prior to delivery for uterine rupture. Patient was on home monitor. Found lying on side co-sleeping w/twin in crib. 10/5/07 Reviewed autopsy report which states COD as SIDS with prone sleeping position; twin gestation & manner of death as natural. Pathologic dx include: premature birth (34 wk), mild right ventricular dilatation and pulmonary edema.


VAERS ID: 288181 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Female  
Location: Texas  
Vaccinated:2007-08-03
Onset:2007-08-09
   Days after vaccination:6
Submitted: 2007-08-14
   Days after onset:5
Entered: 2007-08-15
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B114BB / 1 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF018AA / 1 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B58845E / 1 RL / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Death, Unresponsive to stimuli
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2007-08-09
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Infant Tylenol
Current Illness: NONE
Preexisting Conditions: UMBILICAL HERNIA UNDERWEIGHT
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was found August 9,2007 in between both parents unresponsive. 8/17/07 Received call from provider, will not send vax record but read lot #s to check against report. RO dose & lot # correct as reported; however, 2 other lot #s corrected in VAERS database. 9/25/07 Reviewed Autopsy Report which reveals COD as traumatic asphyxia due to entrapment of head between mattress & headboard. Manner of Death: accident.


VAERS ID: 288471 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Female  
Location: California  
Vaccinated:2007-08-16
Onset:2007-08-17
   Days after vaccination:1
Submitted: 2007-08-20
   Days after onset:3
Entered: 2007-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B114BB / 1 - / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0077U / 1 - / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08700H / 1 - / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0971U / 1 MO / PO

Administered by: Private       Purchased by: Public
Symptoms: Respiratory arrest, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), Respiratory failure (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2007-08-17
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Infant Tylenol
Current Illness: None
Preexisting Conditions: None Umbilical hernia
Allergies:
Diagnostic Lab Data: Unavailable Autopsy Findings: Acetaminophen level 13 mg/L & CAH 17-OHP level abnormal.
CDC Split Type:

Write-up: Prelim reported that pt''s vomited and gone to respiratory arrest. 8/21/07 Spoke w/MD who states patient was in good health on day of vax. Looked tired but exam was WNL. Family concerned only about umbilical hernia. 8/21/07 Received pcp medical records & vax records which confirm RO dose & lot # as reported. Records indicate patient was in good health on day of vax w/only medical concern umbilical hernia. 3/11/08 Autopsy report states COD as undetermined.


VAERS ID: 288631 (history)  
Form: Version 1.0  
Age: 74.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2007-08-02
Onset:2007-08-06
   Days after vaccination:4
Submitted: 2007-08-21
   Days after onset:15
Entered: 2007-08-22
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER LIVE (ZOSTAVAX) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2007-08-06
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Cardiac disorder
Preexisting Conditions: Stroke PMH: mitral valve replacement; atrial fibrillation; pacemaker 8/2006; CVA; TIA; well controlled HTN; right cerebellar stroke; dental prophylaxis antibiotics; endometrial cancer; dyslipidemia; osteopenia; hysterectomy; seasonal allergies. Allergic to sulfa & quinidine.
Allergies:
Diagnostic Lab Data: Unknown LABS: last done 7/26/07, CBC & chemistry WNL. Glucose elevated 142. Digoxin WNL. PT/INR therapeutic.
CDC Split Type: WAES0708USA01838

Write-up: Information has been received from a pharmacy technician concerning a 75 year old (previously reported as "about 75 year old") female "in poor health" with heart problems and a history of stroke and other unspecified medical conditions who on 02-AUG-2007 was vaccinated with a dose of Zostavax. For an unspecified amount of time after vaccination the patient was observed for any reaction. The patient then left the pharmacy without any signs of an untoward reaction. Several days later the pharmacy technician read in the paper obituaries that the patient passed away on 06-AUG-2007. The cause of death was not reported. There was no product quality complaint involved. No further information was available. Additional information has been requested. 08/23/2007 Per email from FDA: A 75 y/o female in poor health with heart problem and a hx of stroke died 3 days after receiving Zostavax. Her name was in newspaper obituaries. She did not experience any immediate AEs after vaccination. Called Meck for follow up information including cause of death. 8/27/07 FDA obtained patient name & DOB from Merck. No autopsy was done. COD was intracranial hemorrhage. Merck will provide additional medical records. 9/7/07 Reviewed pcp medical records which reveal patient on chronic anticoagulant therapy for mitral valve replacement & was seen approx every 2 weeks for labs & eval. Weight & vital signs stable. 10/29/07 Reviewed Death Certificate which states COD as subdural hematoma with anticoagulation for valvular heart disease as contributing factor.


VAERS ID: 288921 (history)  
Form: Version 1.0  
Age: 0.6  
Sex: Male  
Location: Iowa  
Vaccinated:2007-08-21
Onset:2007-08-23
   Days after vaccination:2
Submitted: 2007-08-24
   Days after onset:1
Entered: 2007-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B127AA / 3 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF117AA / 3 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B26510B / 3 RL / IM

Administered by: Public       Purchased by: Public
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2007-08-23
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none - had been in ER 8/1 + 8/2 for pharyngitis + upper resp infection
Preexisting Conditions: None known
Allergies:
Diagnostic Lab Data: See ER notes attached
CDC Split Type:

Write-up: See ER notes attached. 11/27/07 Reviewed autopsy report which states COD as encephalomyelitis due to enterovirus (EV 71) & manner of death as natural. States history as: found supine in crib, unresponsive; no recent illness; no previous medical history;brain swelling; SDH, minimal; SAH, bilateral; microglial clusters, neuronal loss, neuronophagia & mild perivascular lymphocytic infiltrate w/gliosis in keeping with a viral poliomyelitis.


VAERS ID: 289100 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Male  
Location: Illinois  
Vaccinated:2007-08-23
Onset:2007-08-24
   Days after vaccination:1
Submitted: 2007-08-27
   Days after onset:3
Entered: 2007-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B115AA / 1 LL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0077U / 1 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B53981A / 1 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0508U / 1 MO / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Death, Developmental delay, Failure to thrive
SMQs:, Neonatal disorders (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2007-08-25
   Days after onset: 1
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: Microcephalus, underweight BIRTH HX: 38-wk emergency c-section due to deceleration, nuchal cord & decreased amniotic fluid. 6 days in NICU. Parents are 1st cousins (+ consanguinity). Had 5yo sibling deceased w/similar s/s & seizure disorder, apnea & flat head.
Allergies:
Diagnostic Lab Data: LABS: MRI at birth showed areas of hypoplasia of corpus callosum. Echocardiogram done during resuscitation revealed very wide QRS & bradycardia which progressed to EMD w/o any mechanical cardiac funation. Abdomen KUB revealed nonspecific nonobstructive bowel gas patter w/paucity of small bowel gas. CXR WNL. Blood c/s (+) for bacillus species but may have been contaminant.
CDC Split Type:

Write-up: Patient died two days after receiving vaccines. Infant had multiple problems including failure to thrive, and developmental delays. Was admitted with complete heart block. 8/28/07 Spoke w/the reporter on this case who will provide medical records from clinic & hospital as well as a copy of the Death Certificate. No autopsy was done. Reporter stated this child had multiple medical problems & was being followed by several clinic specialists including geneticist. Sibling of this child also had multiple problems & expired at unknown time. 9/7/07 Reviewed medical records & Death Certifiate from reporter. COD stated as complete heart block w/microcephaly & failure to thrive as contributing factors. Vax record confirms dose & Lot # of all vax as reported. Had microcephaly, hypertonia & contractures of UEs noted on d/c from birth hospital. Referred by birth hospital to Easter Seals for developmental therapy eval 7/07. Medical records show that on day of vax had cough & sneeze along w/very slow feeding & poor growth noted. Referred for feeding eval. PCP records indicate patient on home monitor. Neuro, Genetic & Cardio consults. Very slowly gained weight & remained significantly underweight. Genetics eval done 7/07. Developmental delay. Cardiac consult on day of death reveals patient admitted 8/24 for diarrhea & poor feeding then developed slow heart rate & complete heart block. FINAL DX: complete heart block, microcephaly & failure to thrive.


VAERS ID: 289148 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Male  
Location: Alabama  
Vaccinated:2007-08-01
Onset:2007-08-02
   Days after vaccination:1
Submitted: 2007-08-28
   Days after onset:26
Entered: 2007-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B129AA / 1 LL / UN
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF117AA / 1 RL / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08690K / 1 LA / UN

Administered by: Private       Purchased by: Unknown
Symptoms: Death, Sudden infant death syndrome
SMQs:, Neonatal disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2007-08-02
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 12 hr after receiving the vaccine-baby found dead in hotel bed next to his mother Autopsy Dx: SIDS. 8/31/07 Received vax record from pcp which confirm dose & lot as reported. 1/15/08 Reviewed autopsy report which states COD as Undetermined. Found dead in bed. Findings at autopsy included: SIDS; petechial hemorrhages of thymus & pleura; pulmonary edema & congestion; cerebral edema; & patent ductus arteriosus.


VAERS ID: 289543 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Male  
Location: California  
Vaccinated:2007-08-09
Onset:2007-08-10
   Days after vaccination:1
Submitted: 2007-08-13
   Days after onset:3
Entered: 2007-08-31
   Days after submission:18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B124AA / 1 RL / UN
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0077U / 1 LL / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B540138 / 1 LL / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1238F / 1 MO / PO

Administered by: Private       Purchased by: Unknown
Symptoms: Diet refusal, Gaze palsy, Respiratory arrest, Resuscitation
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Ocular motility disorders (narrow), Hypersensitivity (broad), Respiratory failure (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2007-08-10
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Nystatin suspension
Current Illness: thrush, oral umbilical hernia
Preexisting Conditions: sickle-cell trait
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Per ER call to on call physician 8/11. Last night he stopped feeding and then his eyes rolled back and he stopped breathing. 911 called and CPR initiated. Coded for 1-1/2 hours (paramedics and ER) without success. 9/4/07 Received pcp medical records which included vax record which confirmed RO dose & lot #s as reported. Office note of 8/9 indicates well child visit on day of vax excep for thrush & umbilical hernia. 1/8/08 Reviewed autopsy report which states COD as sudden unexplained infant death syndrome due to dilated cardiomyopathy & primary endocardial fibroelastosis, dilated form.


VAERS ID: 290566 (history)  
Form: Version 1.0  
Age: 0.4  
Sex: Female  
Location: California  
Vaccinated:2007-09-05
Onset:2007-09-05
   Days after vaccination:0
Submitted: 2007-09-12
   Days after onset:7
Entered: 2007-09-14
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2650AA / 2 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR A0122 / 2 LL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR Z0872 / 2 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B97283B / 2 LL / IM

Administered by: Private       Purchased by: Private
Symptoms: Autopsy, Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2007-09-05
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Reporter denied the patient had any illnesses, pre-existing medical conditions, use of other medications, or any adverse events following prior vaccinations at the time of the vaccinations on 05 September 2007. It was reported the patient had no known allergies. No vaccines were administered within four weeks prior to the vaccinations on 05 September 2007.
Allergies:
Diagnostic Lab Data:
CDC Split Type: 200703071

Write-up: Initial report received on 10 September 2007 from a health care professional. A four-month-old infant with no concurrent illnesses, no known allergies, and who had no pre-existing medical history, had received a second intramuscular dose of ActHib, lot number UF160AA (Sanofi Pasteur SA lot number A0122-2) in the left thigh; a second intramuscular dose of Daptacel, lot number C2650AA in the right thigh; a second intramuscular dose of IPOL, lot number Z0872-2 (reported as Z0872), in the right thigh; and a second intramuscular dose of Prevnar (manufacturer Wyeth), lot number B97283B, in the left thigh. The patient had not experienced any adverse events following prior vaccinations. Later that evening the patient was "found expired." Reportedly, an autopsy will be completed. 3/19/08 Reviewed autopsy report which states COD as complications of congenital pulmonary malformation. 3/19/08 Autopsy states pathologic diagnoses as: I. Congenital Pulmonary malformation with A. Microscopic characteristics most c/w congenital cystic adenomatoid malformation, Type I B. lymphocytic & macrophage peri-bronchial inflammation, mod to marked C. Intraalveolar hemorrhage, marked D. pulmonary edema, marked III. Abnormal 17 hydroxyprogesterone study w/o microscopic abnormality of adrenal glands.


VAERS ID: 290655 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Male  
Location: Unknown  
Vaccinated:2007-08-30
Onset:2007-09-11
   Days after vaccination:12
Submitted: 2007-09-14
   Days after onset:3
Entered: 2007-09-17
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B132BA / 1 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF162AA / 1 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH - / 1 LL / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Apnoea, Body temperature decreased, Cyanosis, Death, Hypothermia, Musculoskeletal stiffness, Pulse absent, Pupil fixed, Resuscitation, Unresponsive to stimuli
SMQs:, Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Dystonia (broad), Parkinson-like events (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad), Respiratory failure (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2007-09-11
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Family history of atrial fibrillation in the father of the child and allergies in an otherwise healthy 7-year-old sibling.
Allergies:
Diagnostic Lab Data: Body temperature (results: 92.2 deg. F.) was done on 11-Sep-2007.
CDC Split Type: HQWYE111312SEP07

Write-up: This is a 7-day report. This case was unblinded, the patient received Prevnar. Information regarding Prevnar was received from an investigator regarding a 2-month-old male participant in a study who experienced death. The participant received the first dose on 30-AUG-2007. On 11-Sep-2007, the patient was found in the crib at Day Care on his back, unresponsive, blue and not breathing. Day Care workers initiated cardiopulmonary resuscitation and contacted 911 emergency response. Upon emergency medical response arrival , the child was noted to be apneic and pulseless. The patient was intubated without difficulty and cardiopulmonary resuscitation was continued. An intraosseous line was placed in the left lower extremity that was infusing well. A total of 4 doses of epinephrine were given without any response. The child remained apneic and pulseless. Upon arrival to the emergency room the child had blood pooling on the posterior back and neck area. On physical examination pupils were fixed at approximately 2-3 mm. bilaterally and no pulse was noted. The physician also noted hypothermia and stiffness. The patient was pronounced dead at 12:42 in the afternoon at the hospital. The cause of death was reported as unknown. The parents reported the child had been completely healthy up to this point. No additional information was available at the time of this report. The investigator(s) considered death possibly related to the study product. The medical monitor(s) considered death not related to the study product because temporal relationship 12 days after vaccination does not suggest causal relationship.


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