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From the 10/15/2021 release of VAERS data:

Found 3,107 cases where Patient Died and Vaccination Date from '2007-08-01' to '2020-11-30'



Case Details

This is page 13 out of 311

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VAERS ID: 316231 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Male  
Location: North Carolina  
Vaccinated:2008-06-05
Onset:2008-06-08
   Days after vaccination:3
Submitted: 2008-06-13
   Days after onset:5
Entered: 2008-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B149AA / 1 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF349AA / 1 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH C65049 / 1 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0281X / UNK MO / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Cardiac arrest, Death, Upper respiratory tract infection
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (broad), Cardiomyopathy (broad), Respiratory failure (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2008-06-09
   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: Actigall, Ferrous Sulfate
Current Illness: Cholestatic Jaundice, URI sypmtoms 2 days later
Preexisting Conditions: see #7 please note hep B in NICU is unknown type or lot #
Allergies:
Diagnostic Lab Data: Labs and Diagnostics: CBC 6/9/08 WBC 5.6. Lymphs 75.3% Hgb 8.9, Hct 27.4
CDC Split Type:

Write-up: Ex 29-week premature infant presented for routinue post NICU follow-up on 6/5/08 for 2mo. Relatively nml Pexam (hx of RDS,Apnea, R/o spesis, anemia, hyperbilirubinemia, cholestatic jaundice, murmur, bilat inguinal hernia) Of note only jaundice and murmur were present at time of discharge. Patient recieved 4 vaccines on 6/5/08. Patient presented with URI symptoms on 6/9/08 diagnoses with URI and sent home. The baby reportedly had a cardiac arrest later that evening and did not survive. ****please note submission of similar patient of similar event with ALTE diagnosis and hospitalization (survived). 6/27/08 Link w/317530 per direction of FDA. 9/24/08 ER record received for DOD 6/10/08. DX: Sudden Death. CPR unsuccessful. Infant last seen alive at 1800. EMS on scene at 22:35. Pt found cold, stiff and puple in color. CPR attempted but unsuccessful. Pt in rigor upon arrival in ED and prounounced. PMH: 28 wk premie. In NICU from DOB 3/29/08 until 4/29/08 with DX: Respiratory Distress syndrome. Apnea of Prematurity. R/O Sepsis x3. R/O NEC. Jaundice. Nutritional support. R/O IVH and PVL. Temperature Support. Infant on CPAP and NC O2. Had apnea, bradycardia and O2 desats. 3 episodes of sepsis w/u. Had physiologic jaundice requiring phototherapy. On parenteral feeds with intermittant enteral feeds. D/C on O2 and monitoring./pc 9/29/08 ME''s report received. Probable COD Acute Bronchopneumonia. DX: Acute bronchopnemonia, moderate. Cholestasis. Microscopic exam of the lungs reveals moderate acute bronchopneumonia present w/in the major and minor bronchi and alveolar spaces. Focal atelectasis. Liver shows diffuse cholestasis with bile plugs present. Slight chronic inflammation. Severe autolysis. 10/30/08 PCP records received which include d/c summary for 2+month NICU stay with D/C 6/4/08. Seen in f/u 6/5/08-cholestatic jaundice, anemia, ROP and scrotal masses (hydroceles) noted. Otherwise normal premie exam. Vax given. Seen again 6/9/08 for cough and congestion with Impression URI. RR 60. P ox 95%. Wet cough, wheeze and rhonchi noted (clear A/P/L). Nasal saline and suction as sympromatic care. To f/u in 1-2 days or to ER PRN.


VAERS ID: 316952 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Female  
Location: Texas  
Vaccinated:2008-05-01
Onset:0000-00-00
Submitted: 2008-05-06
Entered: 2008-06-23
   Days after submission:48
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B142AA / 1 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF238AF / 1 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08702B / 1 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1231F / 1 MO / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms:
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2008-05-05
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ZMAX
Current Illness: SINUSITUS
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: INFANT IN BED WITH PARENTS AT TIME OF DEATH. 6/30/08 Autopsy report states COD as SID, pt found unresponsive in bed w/parents.


VAERS ID: 316983 (history)  
Form: Version 1.0  
Age: 17.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2008-05-28
Onset:2008-06-12
   Days after vaccination:15
Submitted: 2008-06-16
   Days after onset:4
Entered: 2008-06-23
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0928U / 1 LA / UN

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2008-06-12
   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: Seizures PMH: ''problems w/alcohol''.
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Death 9/9/08 Death certificate states COD as idiopathic seizure disorder. 8/5/08 Reviewed ER medical records of 6/12/2008. Records reveal patient found unresponsive, prone on her bed when parent went to awake for school. Last seen at bedtime. Pupils fixed & dilated, cyanotic & pale, incontinent of urine, developed pulmonary edema during resuscitation. Unable to resuscitate.


VAERS ID: 316985 (history)  
Form: Version 1.0  
Age: 0.5  
Sex: Male  
Location: North Carolina  
Vaccinated:2008-06-11
Onset:2008-06-13
   Days after vaccination:2
Submitted: 2008-06-23
   Days after onset:10
Entered: 2008-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B132CA / 1 LL / IM
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER UF341AC / 1 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH C65047 / 1 RL / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2008-06-20
   Days after onset: 7
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: asthma
Allergies:
Diagnostic Lab Data: 6/26/08-records received-. Liver 7-8cm below costal margin. CK 10,248, lactate 10.9. EKG decreased voltages, elevation of ST segments. Initial BUN 35 and total CO2 16. Blood gas 7.36 and pCO2 30, potassium 4.5.
CDC Split Type:

Write-up: ER visit to hospital Friday 6/13/08. 2nd ER visit to hospital on 6/20/08 - transferred to another hospital. I have not received any medical charts. 6/26/08-records received for DOS 6/20-6/21/08-transferred with history of dehydration and metabolic acidosis on 6/14/08 with subsequent ER visit on 6/20 with similar symptoms. Developed difficulty breathing after 6/11/08 immunizations, with grunting and screaming on 6/12/08. In ED with respiratory distress including retractions, tachypnea, heart rate at 153. On 6/19/08 at 2130 passed large diarrheal stool. Evening prior to admission developed limpness and refused p.o. feedings. Pale, gray and cold to touch. In ED with weak cry, heart rate of 200 and unobtainable blood pressure, respirations 60. Electrocardiogram revealed wide complex tachycardia.Intubated, ventilator Resuscitative efforts. Massive pulmonary edema. Expired at 2355. 12/23/08-autopsy report received-acute congestive heart failure with myocarditis probably viral. mild interstitial pneumonitis, hepatomegaly with centrilobular congestion and necrosis. serous effusions. stress changes in thymus. Diffuse cerebral edema and hyopxic ischemic injury.


VAERS ID: 317385 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Female  
Location: Texas  
Vaccinated:2008-04-14
Onset:2008-04-16
   Days after vaccination:2
Submitted: 2008-05-16
   Days after onset:30
Entered: 2008-06-25
   Days after submission:40
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B142AA / 1 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF215AB / 1 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH C65043 / 1 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1621U / 1 MO / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Diarrhoea, Laboratory test, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2008-04-18
   Days after onset: 2
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: 0~ ()~~0.00~In Patient|0~ ()~~0.00~In Sibling|0~ ()~~0.00~In Sibling
Other Medications:
Current Illness: WELL AT TIME OF VACCINE
Preexisting Conditions: NO
Allergies:
Diagnostic Lab Data: LABS 4/17
CDC Split Type:

Write-up: VOMITING AND DIARRHEA STARTED 4/16 IMPROVED ON 4/17. NO DEHYDRATION TOLERATED PEDIALYTE WELL. DIED AM OF 4/18 AFTER MOM FELL ASLEEP WHITE FEEDING CHILD. 7/2/08-records received-Undetermined causes, no convincing cause of death could be deteremined. The infant may have asphyxiated by various means, including suffoction or positional asphyxia or may have died of other reasons.


VAERS ID: 317407 (history)  
Form: Version 1.0  
Age: 0.4  
Sex: Female  
Location: Michigan  
Vaccinated:2008-03-26
Onset:2008-03-27
   Days after vaccination:1
Submitted: 2008-06-25
   Days after onset:90
Entered: 2008-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B126AA / 2 - / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF229 AA / 2 - / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH C49918 / 2 - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2008-03-27
   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: unknown
Current Illness:
Preexisting Conditions: Child born at 28 weeks gestation. Had hx of RSVP. Had been treated for e-coli & strep infection in past. Low birth wt. Periods of apnea in past. Reported at Child Death Review Meeting of immunizations day before death.
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: See box 19 for information. Baby alive at 5:30 AM & died approx. 6:00 AM. 7/7/08-autopsy report received-COD:Sudden Unexplained Infant Death. Complications of Prematurity.


VAERS ID: 317757 (history)  
Form: Version 1.0  
Age: 15.0  
Sex: Female  
Location: Indiana  
Vaccinated:2008-06-13
Onset:2008-06-15
   Days after vaccination:2
Submitted: 2008-06-27
   Days after onset:12
Entered: 2008-06-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1447U / 1 LA / UN

Administered by: Unknown       Purchased by: Unknown
Symptoms: Cardiomegaly, Death, Passive smoking, Splenomegaly, Toxicologic test normal
SMQs:, Cardiac failure (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2008-06-15
   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: overweight PMH: recurrent colds/sore throat, neg strep.
Allergies:
Diagnostic Lab Data: toxicology and other test came back negative expect trace amount of nicotine (father heavy smoker)
CDC Split Type:

Write-up: Death -coroner says enlarged heart & enlarge spleen 7/4/08 Reviewed PCP medical records of 1999-6/2008 which included vax record. In 8/2007, c/o of tiredness & loss of appetite. Monospot (-). On day of vax, patient was well, weight noted as 237, otherwise no complaints. 7/8/08 Autopsy report states COD as arrhythmia due to cardiomyopathy.States anatomic findings of obesity, pulmonary edema, mild & left ventricular hypertrophy w/myocardial nuclear enlargement. Patient had been found non-responsive by family. EMS found patient cyanotic w/rigor & no further resuscitation was performed. Family reported patient had been well earlier in the evening. Albuterol inhaler was found at scene but no suspicious features at scene.


VAERS ID: 317877 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Female  
Location: Kentucky  
Vaccinated:2008-06-09
Onset:2008-06-25
   Days after vaccination:16
Submitted: 2008-06-26
   Days after onset:1
Entered: 2008-06-30
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B143AA / 1 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF348AA / 1 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH 858845H / UNK LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 02124 / 1 MO / PO

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2008-06-25
   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: Dwarfism-records received 8/29/08- dwarfism; remote SDH; history of c-section;
Allergies:
Diagnostic Lab Data: Dwarfism, Premature at 37 wks
CDC Split Type:

Write-up: Father called 6/25 to cancel appts for August/08 and states baby died of SIDS. 8/29/09 Autopsy report also states: apparently found unresponsive at home in car seat which had been placed in crib;no evidence of acute traumatic injury; post mortem studies all negative. 8/29 Autopsy states COD: no anatomic cause./


VAERS ID: 318120 (history)  
Form: Version 1.0  
Age: 0.4  
Sex: Male  
Location: Illinois  
Vaccinated:2008-07-01
Onset:2008-07-01
   Days after vaccination:0
Submitted: 2008-07-02
   Days after onset:1
Entered: 2008-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B143AA / 2 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR HF366AA / 2 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH C65930 / 2 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0501X / 2 MO / PO

Administered by: Private       Purchased by: Unknown
Symptoms: 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: 2008-07-01
   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: TYLENOL after inj.
Current Illness: None
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt received immunization at approx 10:15 am. Father found unresponsive @ approx 7:15 pm. 8/21/08-cause of death undetermined. pulmonary vascular congestion. petechiae of epicardium.


VAERS ID: 318570 (history)  
Form: Version 1.0  
Age: 0.5  
Sex: Male  
Location: New York  
Vaccinated:2008-07-07
Onset:2008-07-08
   Days after vaccination:1
Submitted: 2008-07-09
   Days after onset:1
Entered: 2008-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B156CA / 3 UN / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF366AA / 3 UN / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH C65930 / 3 UN / IM

Administered by: Private       Purchased by: Public
Symptoms: 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: 2008-07-08
   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: Poly Vi Flor
Current Illness: None
Preexisting Conditions: s/p inguinal hernia repair
Allergies:
Diagnostic Lab Data: Currently examined by medical examiner
CDC Split Type:

Write-up: vaccine 7/7/08 approx 3 pm. Reportedly child fus til 7/8/08 afternoon nap with mom. When mom awoke child unresponsive -$g died 10/20/08-records received-COD Sudden unexpected infant death. Manner of death-undetermined.


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