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

Found 2,925 cases where Patient Died and Vaccination Date from '2010-01-01' to '2020-12-31'



Case Details

This is page 19 out of 293

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VAERS ID: 438770 (history)  
Form: Version 1.0  
Age: 84.0  
Sex: Female  
Location: Illinois  
Vaccinated:2011-10-13
Onset:2011-10-13
   Days after vaccination:0
Submitted: 2011-10-14
   Days after onset:1
Entered: 2011-10-17
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUARIX) / GLAXOSMITHKLINE BIOLOGICALS AFLUA609AA / UNK LA / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Asthenia, Atrial fibrillation, Confusional state, Death, Dehydration, Fall, Mental status changes, Pallor, Vomiting
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Supraventricular tachyarrhythmias (narrow), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2011-10-14
   Days after onset: 1
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: FOSAMAX; CALTRATE D; RELAFEN
Current Illness: Rapid H.R.; Weakness; Paleness
Preexisting Conditions: Asthma; Osteoporosis; Prosthetic eye; Osteoarthritis; Breast CA; Allergy = strawberries.
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt. had emesis that she vomited on the floor, she then tried getting up & fell. Resident was confused, weak, & had pale color. Sent to ER for evaluation. ER called at 1:22am & said she was admitted with A-fib, dehydration, rapid ventricular response, & mental status changes.


VAERS ID: 438876 (history)  
Form: Version 1.0  
Age: 84.0  
Sex: Male  
Location: New York  
Vaccinated:2011-10-03
Onset:2011-10-03
   Days after vaccination:0
Submitted: 2011-10-18
   Days after onset:15
Entered: 2011-10-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR UH462AC / 1 RA / IM

Administered by: Other       Purchased by: Private
Symptoms: Activities of daily living impaired, Blood culture positive, CSF protein increased, Culture urine positive, Dysstasia, Endotracheal intubation, Escherichia urinary tract infection, Guillain-Barre syndrome, Hypoaesthesia, Hypokinesia, Immunoglobulin therapy, Lumbar puncture, Mechanical ventilation, Paraesthesia, Plasmapheresis, Sensory loss, Sputum culture positive, Staphylococcal infection, Streptococcal bacteraemia, Walking aid user
SMQs:, Angioedema (broad), Peripheral neuropathy (narrow), Dementia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Demyelination (narrow), Hypotonic-hyporesponsive episode (broad), Respiratory failure (broad), Infective pneumonia (broad), Sepsis (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (narrow), Sexual dysfunction (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2011-10-23
   Days after onset: 20
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 18 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: no
Allergies:
Diagnostic Lab Data: LP- positive for protein
CDC Split Type:

Write-up: Pt had numbness and tingling of his finger tips on same evening as recieving flu shot that morning. On next day, Tuesday, he started same numbnes and tingling in his toes. Pt went to family doctor on Wednesday and needed walker to assist him in walking. (Prior to this event the pt was able to ambulate without assistance of any devices, drive a car long distances and grocery shop on own) pcp- sent pt to the ER for evaluation. Pt was diagnosed as having Guillain Barre syndrome from the flu shot. By 9 pm that Wednesday evening he was not able to stand and pt had limited use of his arms. Pt was admitted to hospital. By 9am on Thursday pt had little movement and no feeling in legs. He had very little movement of his arms and was not able to lift his arms to his mouth to feed himself. By Thursday night pt was intubated and placed on ventilation support. By Friday am he was not able to move any extremities and only had movement of his head, mouth and shoulder shrugs. Immunoglobulin administration was started on Wed afternoon and continued for 5 or 6 doses (one each day). No improvement was seen. Pt subsequently developed several infectious processes-e-coli in urine, staph (not MRSA) in his sputum, and strep in his blood. Plasmaphoresis was started every other day times 5 exchanges. (Was have finished 3 exchanges up to this time with no movement of extremities seen.


VAERS ID: 439082 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Male  
Location: Washington  
Vaccinated:2011-10-13
Onset:2011-10-13
   Days after vaccination:0
Submitted: 2011-10-19
   Days after onset:6
Entered: 2011-10-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3931AA / 1 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 916304 / 1 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1311AA / 1 MO / PO

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2011-10-13
   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: No medications reported
Current Illness: None described
Preexisting Conditions: None described
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: None stated.


VAERS ID: 439084 (history)  
Form: Version 1.0  
Age: 90.0  
Sex: Female  
Location: Michigan  
Vaccinated:2011-09-09
Onset:2011-09-10
   Days after vaccination:1
Submitted: 2011-10-06
   Days after onset:26
Entered: 2011-10-19
   Days after submission:13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE) / SANOFI PASTEUR UH4398A / UNK LA / IM

Administered by: Other       Purchased by: Private
Symptoms: Chest pain, Dysphonia, Hypokinesia, Pain, Swollen tongue, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Asthma/bronchospasm (broad), Parkinson-like events (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2011-09-10
   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:
Current Illness: None (see above dx.)
Preexisting Conditions: (See above)
Allergies:
Diagnostic Lab Data: Heart Disease (CHF); Thyroid; Kidney (4% operating)
CDC Split Type:

Write-up: Received High dose flu shot 9/9/11 within 12 hr had chest pain, hoarseness, wheezing, decreased movement arm/shoulder, decreased movement in face, body ache, tongue swelling. Daughter reporting.


VAERS ID: 439265 (history)  
Form: Version 1.0  
Age: 67.0  
Sex: Male  
Location: Florida  
Vaccinated:2011-09-21
Onset:2011-10-07
   Days after vaccination:16
Submitted: 2011-10-17
   Days after onset:10
Entered: 2011-10-20
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE) / SANOFI PASTEUR UH444AB / 2 LA / UN

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2011-10-07
   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: Rectal carcinoma; Delirium
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Death.


VAERS ID: 439266 (history)  
Form: Version 1.0  
Age: 66.0  
Sex: Male  
Location: Florida  
Vaccinated:2011-09-12
Onset:2011-10-10
   Days after vaccination:28
Submitted: 2011-10-17
   Days after onset:7
Entered: 2011-10-20
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE) / SANOFI PASTEUR UH444AB / 2 LA / UN

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2011-10-10
   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:
Current Illness:
Preexisting Conditions: Gastric adenocarcinoma; CAD; COPD; Afib; HTN; AVR; Dementia; Seizure disorder; CHF
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Death.


VAERS ID: 439267 (history)  
Form: Version 1.0  
Age: 94.0  
Sex: Male  
Location: Florida  
Vaccinated:2011-09-20
Onset:2011-10-14
   Days after vaccination:24
Submitted: 2011-10-17
   Days after onset:3
Entered: 2011-10-20
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE) / SANOFI PASTEUR UH444AB / 2 LA / UN

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2011-10-14
   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: CAD; HTN; Arthritis; Confusion/delirium
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Death.


VAERS ID: 439269 (history)  
Form: Version 1.0  
Age: 92.0  
Sex: Male  
Location: Florida  
Vaccinated:2011-09-19
Onset:2011-10-16
   Days after vaccination:27
Submitted: 2011-10-17
   Days after onset:1
Entered: 2011-10-20
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE) / SANOFI PASTEUR UH444AB / 2 RA / UN

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2011-10-16
   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: CHF; A fib; CAD
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Death.


VAERS ID: 439567 (history)  
Form: Version 1.0  
Age: 0.18  
Sex: Male  
Location: Texas  
Vaccinated:2011-10-20
Onset:2011-10-21
   Days after vaccination:1
Submitted: 2011-10-21
   Days after onset:0
Entered: 2011-10-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B305AA / 1 LL / UN
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UH344AA / 1 LL / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 91660 / 1 RL / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FA902A / 1 MO / PO

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2011-10-21
   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: 35 weeks
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Baby expired around 6AM on 10-21-11 as per the grandmother''s call to the office at 0900 (approx).


VAERS ID: 440304 (history)  
Form: Version 1.0  
Age: 0.16  
Sex: Male  
Location: Kentucky  
Vaccinated:2011-10-20
Onset:2011-10-22
   Days after vaccination:2
Submitted: 2011-10-25
   Days after onset:3
Entered: 2011-10-26
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C3686AA / 1 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR C3806AA / 1 LL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR C3686AA / 1 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH 915383 / 1 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1268Z / 1 MO / PO

Administered by: Public       Purchased by: Public
Symptoms: Apnoea, Autopsy, Cyanosis, Death, Pulse absent, 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), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Respiratory failure (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2011-10-22
   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: None
Allergies:
Diagnostic Lab Data: Autopsy results pending.
CDC Split Type:

Write-up: Per report received from hospital, Pt. was pulseless, apneic, cyanotic unresponsive upon arrival. Father doing CPR upon EMS arrival. Pt. pulseless per report. Grandmother reported child "was fine" at 1:00 AM.


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