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From the 11/26/2021 release of VAERS data:

Found 3,123 cases where Patient Died and Vaccination Date from '2007-08-01' to '2020-11-30'

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Case Details

This is page 20 out of 313

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VAERS ID: 334606 (history)  
Form: Version 1.0  
Age: 77.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2008-11-14
Onset:2008-11-20
   Days after vaccination:6
Submitted: 2008-12-09
   Days after onset:19
Entered: 2008-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2768AA / UNK LA / IM
YF: YELLOW FEVER (YF-VAX) / SANOFI PASTEUR UF307AB / UNK RA / SC

Administered by: Unknown       Purchased by: Unknown
Symptoms: Antibody test negative, Asthenia, Blood culture negative, Computerised tomogram normal, Confusional state, Cytomegalovirus test negative, Death, Dyspnoea, Ehrlichia serology, Endotracheal intubation, Haemodynamic instability, Herpes simplex serology negative, Hypotension, Intensive care, Malaise, Mechanical ventilation, Multi-organ failure, Nausea, Polymerase chain reaction, Pyrexia, Renal failure, Respiratory failure, Sepsis syndrome, Septic shock, Tachycardia, Tachypnoea
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Dementia (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (narrow), Hypersensitivity (broad), Tumour lysis syndrome (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Dehydration (broad), Hypokalaemia (broad), Sepsis (narrow), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2008-12-03
   Days after onset: 13
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 10 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: 1. Avandaryl 4/2. 2. Triamterene 37.5/25. 3. Tricor 145 mg p.o. daily. 4. Zocor 40 mg q.h.s. 5. Precose 300 mg q.a.c. 6. Metformin 1000 mg p.o. b.i.d. 7. Coumadin 2.5 daily, was not taking at the time of this DVT developing. 8. Hydr
Current Illness: Also see #7 1.Hypertension. 2. Diabetes mellitus type 2. 3. Diverticulosis with hemorrhage. 4. Hyperlipidemia. 5. Bright red blood per rectum. 6. DVT in July 2004.FL 5 def
Preexisting Conditions: also see #7 ALL: NKDA 12/3/09 records received-PMH:DVT/PE,DM, HTN, factor V Leiden.
Allergies:
Diagnostic Lab Data: Yellow fever serum RT PCR: negative,LEPTOSPIRA ANTIBOD. neg, HSV 1/2 QUALITATIVE, PCR- neg,CMV DNA- neg, ehrlichia- neg, Blood cultures neg, CT head, abd, pelvis, brain - negative 2/3/09-records received-MRI brain no evidence of acute intracranial lesions. MRI spine multi level degenerative disease. 2/11/09-laboratory reports received-YF IgM antigen positive. YF arboviral nucloic acid negative.
CDC Split Type:

Write-up: Patient is a 77-year-old male with a history of factor V Leiden, hyperlipidemia, prior history of DVTs, and diabetes mellitus type 2, who presented to the hospital on 11/21/2008 complaining of 2 days of fever, nausea, and generalized weakness and malaise. Pt had Yellow Fever vaccination on 11/14/08 prior to his planned trip abroad. Pt has been otherwise in good health prior to admission. Influenza vaccine was given on 10/30/08. HOSPITAL COURSE: The patient quickly progressed to hemodynamic instability and sepsis syndrome exhibited by tachypnea, tachycardia, hypotension and confusion. Therefore, he was transferred to the MICU on 11/22/2008. The patient was intubated for airway protection at that time and increased work of breathing. The patient required vasopressor support for his blood pressure and was started on broad-spectrum antibiotics. The patient subsequently developed multiorgan system failure, including respiratory failure requiring ventilator support, and oliguric renal failure requiring hemodialysis support. Multiple cultures were sent to try and determine the etiology of the patient''s symptoms and reason for septic shock. It was noted the patient was on broad-spectrum antibiotic, antiviral and antifungal coverage. No specific infection inciting these symptoms was ever identified. The only cultures that were positive were drawn from the patient''s access lines, which grew out Candida albicans. Infectious Disease was following along with the patient the entire time of his stay in the MICU. Over the ensuing days, the patient failed to progress and actually worsened from 12/02 and 12/03 as exhibited by increased tachypnea and work of breathing, hypotension with continued pressor support, and oozing from some of his lines and orifices. At this time, the patient''s family requested that the patient be made DNR and that supportive measures be withdrawn. Therefore, these steps were undertaken on the afternoon of 12/03/2008. The patient passed away officially at 1425 on 12/03/2008. Physical exam was performed to confirm the patient''s death. The family was offered autopsy and declined. 2/3/09-records received for DOS 11/21-12/03/08-C/O Presented to ED with C/O malaise, weakness, nausea, fever and fatigue. Mechanical ventilation. Sepsis. Metabolic acidosis. Septic encephalopathy. 3/30/09-COD multi-organ failure. Septic shock.


VAERS ID: 334611 (history)  
Form: Version 1.0  
Age: 19.0  
Sex: Female  
Location: Illinois  
Vaccinated:2008-11-26
Onset:2008-12-08
   Days after vaccination:12
Submitted: 2008-12-10
   Days after onset:2
Entered: 2008-12-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUN3: INFLUENZA (SEASONAL) (FLUMIST) / MEDIMMUNE VACCINES, INC. 500569P / UNK - / -
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0070X / 3 LA / -
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2730AA / UNK RA / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Autopsy, Death, Headache, Malaise
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2008-12-08
   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: None known. ?? oral contraceptive or an antibiotic for acne.
Current Illness: None.
Preexisting Conditions: Acne. PMH: PCN allergy. Acne. On OCs (Yaz). 12/10/2008 Recived records from health center via CDC. Seen 11/3/08 with c/o sore throat, cough, muscle aches and nasal d/c. PE (+) for pharyngeal erythema, purulent nasal drainage, nasal turbinate changes, and lymphadenopathy. Assessment: Probable viral URI with ? sinusitis. Tx: Biaxin.
Allergies:
Diagnostic Lab Data: Autopsy performed 12-9-08 was unrevealing per family verbal report to me; no signs of intracranial bleed, meningitis, cardiomyopathy, trauma. Toxicology report still pending at this time. Post-mortem tox screen (-).
CDC Split Type:

Write-up: Patient, a previously healthy 19 year-old female college freshman died suddenly yesterday, approximately 10 days after receiving Gardasil & menningococcal vaccines. Vaccines were administered by a medical provider in her hometown while she was home for the Thanksgiving holiday, sometime around 11-28-08. She had a medical appointment pending for 12-8-08 (the day of her death) with the Student Health Service; medical clerk had entered "possible seizure" as the reason for making the appointment. Patient had no history of epilepsy. She complained of a headache and not feeling well in the 24 hours prior to her death. She went to bed at 10:30 PM on 12-7-08, in her dorm room with a roomate. She appeared to still be sleeping the next morning when her roomate left for class. Her body was discovered still in bed around 5 PM that day (12-8-08) with rigor mortis. No history of substance abuse, alcohol intake, or depression or other mental health issues. She was a happy, achieving student. This report is filed by a friend of patient''s parents, who is a physician (board certified internal medicine & geriatrics). Report also filed online today with the FDA. Patient''s mother can be reached at home for additional details. Memorial service & funeral 12-12-08 and 12-13-08. Only known past medical history requiring physician attention was facial acne. 12/10/2008 Recived records from health center via CDC. Seen 11/3/08 with c/o sore throat, cough, muscle aches and nasal d/c. PE (+) for pharyngeal erythema, purulent nasal drainage, nasal turbinate changes, and lymphadenopathy. Assessment: Probable viral URI with ? sinusitis. Tx: Biaxin. Received from CDC via email: The patient had no previous health problems. She was a freshman and was seen at the college health clinic only once on 11/3/08 for sinusitis. She was on Yaz birth control pills and a topical acne medication. After the death, police questioned her roommate who said that the pt did go out on the evening of 12/6/08 and had a few alcoholic drinks, but not an excessive amount. She had a HA the next day and thought it was from the alcohol. She had a PCN allergy and was a non smoker. 12/11/2008 Records received from PCP. HPV#1 1/18/2008. HPV#2 3/28/2008. Vaccines deferred 7/29/2008 2'' to oral prednisone usage for acne (with Bactrim). Seen 8/15/08 for sore throat, runny nose. DX: Pharyngitis s/p steroid tx. Returned for vaccines 11/26/2008 in good health with normal exam. Additional record also received from health center for scheduled appt on 12/8/08. Pt reported 2 episodes (one 1 month ago and one on the day of death) of waking up in a cold sweat, having urinated in the bed, feeling the urge to vomit, dizzy with trouble reading. Appt made for ? seizure. Pt did not arrive for appt. 3/3/09 Autopsy report received. COD: Unable to ascertain after autopsy, microscopic, toxicologic and chemical evaluation.


VAERS ID: 335226 (history)  
Form: Version 1.0  
Age: 0.3  
Sex: Female  
Location: Washington  
Vaccinated:2008-11-13
Onset:2008-11-13
   Days after vaccination:0
Submitted: 2008-12-13
   Days after onset:30
Entered: 2008-12-14
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR - / 1 UN / UN
HEP: HEP B (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH - / 1 - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Brain injury, Death, Decreased appetite, High-pitched crying, Hypotonia, Irritability, Respiratory arrest, Retinal haemorrhage, Skin warm, Sleep disorder, Somnolence
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Retinal disorders (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Neonatal disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (broad), Respiratory failure (narrow), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2008-11-17
   Days after onset: 4
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: i had taken to the same neighborhood health clinic about 2 weeks prior as a walkin for symtoms of a cold they had told me to use sayline drops for congestion and that if things got worse to bring her back in i wanted to but there was nothing they could do but just wait and see if it would get worse or get better and sent us home and also on her 2 week check up on august 22 2008 she was not back up to birth weight and the doctor was not even concerned the 2 week check up was the only time her docotor had seen her the other 2 only a nurse had seen her
Preexisting Conditions: none. PMH:URI 10/18/08
Allergies:
Diagnostic Lab Data: none at this time allegations are retinal hemorrhage she had passed away on Sunday November 16 2008 in hospital. Labs and Diagnostics: CBC with 19.3 WBCs-24% lymphs, 24% bands, 1 metamyelocyte. K+ 7.7. Head CT (+) for cerebral edema and diffuse loss of gray-white differentiation-no intracranial hemoorhage or skull fx. Bone scan (+) for sutural diastasis. No fractures. Arterial gases abnormal. APTT 52. Fibrinogen 225 (L). D dimer $g20. Thrombin time 21. UC (+) for Enterobacter and E. coli. Blood cx (-). Metabolic panel (+) for elevated 17 hydroxyprogesterone
CDC Split Type:

Write-up: I would like some help to find out if my daughters death was caused by a Vaccine Induced Reaction. This all started on November 13 2008. This is the day the i took my daughter to the clinic. She was supposed to be seen for her 2 month well child exam which she was was not. The primary doctor had only seen her once and this was on her 2 week well child exam. When we went in for her 2 month checkup we had seen a nurse practitioner. The doctor never came into see her not even once on this day nor did the nurse weigh her do any of the measurements of check to make sure that everything was growing normally. She had me sign for 2 vaccines when after all this i found out that she was given for 2 that i didn''t know about. We were sent home right after the vaccines were given and told to come back in 4 weeks for more and to expect drowsiness, fussiness, low appetite, not sleeping, irritability, that''s what had happened Thursday night. She slept most that afternoon and evening with very little to eat. Friday morning she was a little fussier then usual. Later on into the day we had noticed her to be warm to the touch but i had checked and it was normal a few more hours into the night. She developed a fairly high pitched cry and it seemed like she had a belly ache but yet eating very much. She was up about every 30 min during that Friday night and she usually was a really good sleeper through the night. On saturday morning i had gotten up to feed her i made a 6 oz bottle she still had about 2 oz left. When she was finished i burped her changed her she was still really fussy so i laid her down on a u shaped pillow and put her on her belly and i laid down beside her and patted her on her bottom and i fell back asleep next to her and was woke up by her father that had just gotten out of bed and told me to make sure the baby is breathing. I grabbed her and her body was limp but still warm to touch. I held her close to my body and ran across the street to the police station where the ambulance had responded and took us to the hospital. They were able to resuscitate her but she could not breath on her own nor did she have any brain function. They then air lifted us to the hospital. After being there for 24 hours the doctor had told us that our baby was not going to live and they see retinal hemorrhaging in the back of the eyes and the only 2 ways were a car wreck or some body had to of shaken her. Well i know that that is not what happened and i have research about these vaccines and all the signs start the day she was vaccinated. Thank you for your time. 01/08/2009 MR received for DOS 11/15-16/2008. Pt presented to ER following parent finding infant unresponsive and not breathing. CPR and intubation initiated at local fire station. Upon arrival, infant was pulseless, pink, hypoxic and hyperthermic. Epi administered with return of pulse but BP fluctuations. Pt acidotic with dilated, unresponsive pupils, asymmetric lung sounds, fungal diaper rash. Trasfered to higher level of care s/p cardiorespiratory arrest, now acidotic and hyperthermic with epi dependent BP. Upon arrival infant was hypothermic with T=35 with shivering, unresponsive to stimulation. Pupils non-reative, (+) retinal hemorrhages, areflexia, flaccid tone. (+) respiratory and metabolic acidosis. Assessment: hypoxic brain injury. Prognosis poor. No brain activity. Ventilator support withdrawn. Pt expired. . 1/14/09 Autopsy report received with COD Anoxic Encephalopathy of unknown etiology. Bilateral Retinal Hemorrhages. Metabolic panel (+) for elevated 17 hydroxyprogesterone. No evidence of physical injury. Manner of death undetermined.


VAERS ID: 335284 (history)  
Form: Version 1.0  
Age: 20.0  
Sex: Male  
Location: Maryland  
Vaccinated:2008-08-16
Onset:2008-11-01
   Days after vaccination:77
Submitted: 2008-12-12
   Days after onset:41
Entered: 2008-12-15
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEN: MENINGOCOCCAL (MENOMUNE) / SANOFI PASTEUR UE489AA / UNK UN / UN

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2008-11-17
   Days after onset: 16
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: PMH: meningococcal meningitis 10 years prior to admission. Allergy: ceclor, cleocin.
Allergies:
Diagnostic Lab Data: LABS: Blood c/s (+) for Neisseria meningitidis serogroup Y. CXR c/w ARDS. EEG abnormal c/w severe diffuse encephalopathy. Creatinine 4.34(H), potassium 5.9, CO2 14(L), anion gap 21(H), calcium 6.3(L), phosphorous 7.7(H), protein 3.2(L), albumin 1.7(L), bilirubin 3.3(H), alk phosphatase 182(H), AST 8881(H), ALT 5540(H), cpk 2204(H), CKMB 25(H), troponin 1 0.73(H), BNP 892(H), lactic acid 13.2(H), D-Dimer .20000(H), PT/PTT/INR (H). CBC: RBC 2.40, H/H 7.4/20.6, plts 11(all low), WBC 19.2(H). LABS: TEE revealed increased right atrial pressure. Head CT c/w diffuse cerebral edema w/acute hemorrhage & possible septic emboli, IVH, hydrocephalus. Cerebral perfusion scan c/w brain death.
CDC Split Type:

Write-up: Pt with a history of menigitis at 10 yrs old. Vaccinated with MENOMUNE prior to college entrance. Contracted meningitis and passed away at age 19 on 11/20/08. MD stated he will fill out VAERS himself and fax to agency. No further info provided. 1/27/09 Death certificate states COD as disseminated intravascular coagulation w/meningococcemia as contributing factor. DOD corrected to 11/17/2008. 12/31/08 Reviewed hospital medical records of 11/13-11/14/2008. FINAL DX: septic shock w/multiorgan failure, DIC, respiratory failure, acute renal failure, lactic acidosis, metabolic acidosis & suspected meningococcemia Records reveal patient experienced myalgia, malaise, generalized aching, nausea, vomiting, diarrhea, fever, petechial rash, sweating, photophobia, neck stiffness, SOB, abdominal pain, back pain. Taken to hospital. Intubated in ER & admitted to ICU in isolation. Exam revealed tachycardia, hypotension(on pressors), anasarca, fever, thrombocytopenia, coagulopathy. Renal, ID, pulmonary consults done. Tx w/IV antibiotics, pressors, steroids, blood product transfusions & hemodialysis. Transferred to higher level of care. 01/14/09 Reviewed hospital medical records of 11/14-11/17/2008. FINAL DX: meningococcemia; purpura fulminans; multiorgan system failure. Records reveal patient experienced purpura fulminans. Had been transferred from outlying hospital. Noted to have had HA in addition to other presenting symptoms as noted in prior records. Tx w/CVVHD, antibiotics & pressors. Developed atrial fib/flutter & was cardioverted. Developed ARDS, acites & anasarca.


VAERS ID: 335418 (history)  
Form: Version 1.0  
Age: 0.17  
Sex: Female  
Location: Minnesota  
Vaccinated:2008-12-04
Onset:2008-12-06
   Days after vaccination:2
Submitted: 2008-12-11
   Days after onset:5
Entered: 2008-12-16
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B173AA / 1 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF400AA / 1 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH C71975 / 1 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0926X / 1 MO / PO

Administered by: Private       Purchased by: Private
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: 2008-12-06
   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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Child seen in clinic 12-4-08 - well child visit with vaccines given. Child put to bed 12-6-08 on stomach. Unresponsive two hours later by parents at home.2/20/09-autopsy report received-Sudden unexplained infant death, prone sleeping position. Minute foci of pneumonia.


VAERS ID: 335622 (history)  
Form: Version 1.0  
Age: 73.0  
Sex: Male  
Location: Kansas  
Vaccinated:2008-10-16
Onset:2008-10-18
   Days after vaccination:2
Submitted: 2008-12-18
   Days after onset:61
Entered: 2008-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR 2761AA / UNK LA / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Biopsy brain abnormal, Death, Demyelination, Gait disturbance, Hemiparesis, JC virus infection, Laboratory test abnormal, Nuclear magnetic resonance imaging brain abnormal, Progressive multifocal leukoencephalopathy, Speech disorder
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Parkinson-like events (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Optic nerve disorders (broad), Demyelination (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Hypoglycaemia (broad), Opportunistic infections (narrow), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2008-12-11
   Days after onset: 54
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 34 days
   Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Albuterol-2 puffs QID, Flovent-1 puff QD, Avapro 150mg PO QD, Calcium Carbonate 1 tablet PO QD, Lasix 40mg PO QD, Asprin 81mg PO QD, Fish Oil 1000mg PO QD, Plavix 75mg PO QD, Prandin 2mg PO QD, Zocor 40mg PO QD.
Current Illness: None
Preexisting Conditions: COPD- well controlled, Diabetes Type 2, wel controlled. PMH: DM, Dyslipidemia, COPD, HTN, ? CHF, Allergies to sulfa, PCN, doxycycline, yellow dye #2.
Allergies:
Diagnostic Lab Data: 11/10/08 MRI: Acute Inflamatory process in both frontal lobes crossing the Corpus Callosum, consistent with encephalitis. On 11/24/08, open brain biopsy showed demyelination consistent with progressive multifocal leukoencephalopathy. On 12/08/08, testing showed the presence of JC Virus. Labs and Diagnostics: MRI brain (+) for possible subacute R frontal stroke, later determined to be acute inflammatory process. Repeat showed progression. MRA (+) for severe focal stenosis. LP showed no sign of infection. Myelin basic protein elevated. Neuron specific enolase (+). EEG (+) for background slowing. PCR and viral tests for HSV, CMV, HZV, West Nile, enterovirus, EBV, Lyme all (-). CXR (+) for atelectasis and possible pleural effusion. Brain bx (+) for JC virus.
CDC Split Type:

Write-up: Pt initally presented to hospital on 10/20-10/26/08 with gait instability, garbled speech and Left sided weakness. Pt was re-admitted to hospital on 11/20-11/23/08 with worsening weakness, increasingly garbled speech and severe gait instability. Pt. transferred to hospital on 11/23/08 for a brain biopsy. Brain Biopsy revealed demyelination consistent with progresive multifocal Leukoencephalopathy. Pt''s neurological status deteriorated until pt expired on 12/11/08. 11/22/2008 MR received for multiple admissions beginning ~10/20/2008. Pt expired 12/11/08 with COD Progressive Multifocal Leukoencephalopathy. Pt presented to local hospital 10/20-26/08 with respiratory distress and admitted for COPD exacerbation and CHF. Also having sx of L sided weakness attributed to possible TIA. Pt d/c but developed increasing L-sided weakness and hemineglect and readmitted 11/10/08 with D/C DX: Immunogenic encephalitis s/p vaccination, Diabetes with hyperglycemia on steroids, COPD. Pt was acting confused with abnormal behavior c/w encephalitis. Started on antiviral and steroids w/o improvement. Pt continued to progress with worsening psychomotor retardation. Pt transferred to rehab for several days and admitted agian 11/19/08 for brain biopsy. D/C DX: Infiltrative bilateral frontal lobe process, extending into the brain stem, possible postvaccinal encephalomyelitis. COPD, Dyslipidemia. Basilar artery stenosis, HTN, DM, DVT risk, morbid obesity. Brain bx (+) for JC virus which lead to dx of PML. Pt with decreasing LOC. Transferred to hospice care. Pt expired 12/11/2008. 2/5/09 Death Cert received. COD: Progressive Multifocal Leukoencephalopathy.


VAERS ID: 336129 (history)  
Form: Version 1.0  
Age: 0.5  
Sex: Female  
Location: Mississippi  
Vaccinated:2008-12-15
Onset:2008-12-17
   Days after vaccination:2
Submitted: 2008-12-22
   Days after onset:5
Entered: 2008-12-29
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3174AA / 1 LL / UN
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U2797CA / 1 LL / UN
HEP: HEP B (FOREIGN) / MERCK & CO. INC. 1719U / 2 RL / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH C52997 / 3 RL / UN

Administered by: Public       Purchased by: Public
Symptoms: Asphyxia, Autopsy, Death
SMQs:, Acute central respiratory depression (broad), Hostility/aggression (broad), Respiratory failure (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2008-12-17
   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:
Current Illness: Cough congestion
Preexisting Conditions: Reflux
Allergies:
Diagnostic Lab Data: Autopsy - report showed accidental suffocation as COD.
CDC Split Type:

Write-up: Death - Mom discovered infant''s head wedged between pillow and bed Thursday morning. 1/2/09-autopsy report received-COD 1. Compressive asphyxia. Compressive markings of skin of chest, shoulders and sides of face. Pulmonary atelectasis. Dilated heart, hypoxic myocardium. Congested cyanotic brain and viscera. Petechiae in epicardium, pleurae and thymus glad. Aspiration of gastric contents. Bilateral enlarged renal pelves, stenotic ureteropelvic junctions, right more than left.


VAERS ID: 336403 (history)  
Form: Version 1.0  
Age: 60.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2008-09-29
Onset:2008-09-29
   Days after vaccination:0
Submitted: 2008-12-23
   Days after onset:85
Entered: 2009-01-05
   Days after submission:13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR 42762AA / 4 UN / IM

Administered by: Private       Purchased by: Private
Symptoms: Chest discomfort, Death, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2008-09-29
   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: LEVAQUIN; LOPRESSOR; NEURONTIN; ELAVIL
Current Illness: No acute illness
Preexisting Conditions: Pernicious anemia; CAD; MI; Lumbar disc disease; Peripheral neuropathy; Hypothyroidism; Cardiomyopathy; GERD; Cervical disc disease; Nonunion R hip fx-repaired; AODM; BPH; MOTRIN; MYCARDIS; PREVACID; FLOMAX; trimethoprim 1/7/09-records received-PMH: CHF, pancreatitis, UTI, Diabetic, coronary stents. Stroke.
Allergies:
Diagnostic Lab Data: 1/7/09-records received-Chest x-ray infiltrate at left lung base and possible infiltrate right upper lobe.
CDC Split Type:

Write-up: Chest tightness, shortness of breath, and rapid demise to death within 4 hours of receiving vaccine. 1/7/09-records received for ED DOS 9/29/08-presented to ED with C/O chest pain, while enroute to ED became diaphoretic, SOB required cardioconversion, intubation. V fib. DX and COD-Pulmonary embolus. Expired 9/29/08. 2/9/09-COD-pulmonary embolism.


VAERS ID: 336473 (history)  
Form: Version 1.0  
Age: 18.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2007-08-07
Onset:2007-09-01
   Days after vaccination:25
Submitted: 2008-12-23
   Days after onset:479
Entered: 2009-01-05
   Days after submission:13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0804F / 1 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0171U / 1 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2207AA / 1 RA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2457AA / 1 LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Asthenia, Biopsy muscle, Death, Dysphagia, Fatigue, Headache, Immunoglobulin therapy, Muscle atrophy, Myalgia, Nuclear magnetic resonance imaging, Pain in extremity, Weight decreased
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2009-03-23
   Days after onset: 569
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Iron-deficiency anemia
Allergies:
Diagnostic Lab Data: muscle biopsy; MRI separate. Dx clinical myositis
CDC Split Type:

Write-up: Onset increased muscle pain, fatigue, weakness, dysphagia, weight loss. Pt requiring Prednisone IVIG every q monthly. Methotrexate headache, muscle atrophy. 2/6/09 Received PCP medical records of 11/11/08-1/20/09. FINAL DX: polymyositis, likely MCV4 vaccine related; osteomalacia; neuropathy; pernicious anemia; tachycardia; ataxia; Budd-Chiari syndrome; dermatomyositis. Records reveal patient experienced muscle weakness, paresthesias, leg pain. Referred to Neuro & Rheum. Tx w/PT & meds including methotrexate, imuran, steroids, enbrel, bicillin, IVGG. Had to drop out of college due to illness. 04/6/2010 Patient''s condition never improved and she died on 3/23/2009.


VAERS ID: 336654 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Male  
Location: North Carolina  
Vaccinated:2008-12-29
Onset:2008-12-30
   Days after vaccination:1
Submitted: 2008-12-31
   Days after onset:1
Entered: 2009-01-07
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3241AA / 1 LL / IM
HEP: HEP B (FOREIGN) / MERCK & CO. INC. 0725X / 2 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH D01075 / 1 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0926X / 1 MO / PO

Administered by: Private       Purchased by: Public
Symptoms: Asthenia, Death, Frequent bowel movements, Hypophagia, Hypothermia, Lethargy, Mucous stools, Shock
SMQs:, Anaphylactic reaction (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Hypovolaemic shock conditions (narrow), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypoglycaemic and neurogenic shock conditions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2008-12-30
   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: Pt seen 12/27/08 with c/o spitting up blood and sneezing. Dx with thrush and tx with Diflucan. Returned to PCP 12/29/08, impetigo noted
Preexisting Conditions: Prematurity 34 wks. PMH: 34 week premie
Allergies:
Diagnostic Lab Data: State examiner case pending.
CDC Split Type:

Write-up: Pt developed decreased PO intake and increased frequency of stools with mucus on the night of 12/29/08 < 12 hours after immunizations. Next day continued to have poor intake and increased stool and became weak/lethargic. Pt came to evening clinic and was in state of shock and hypothermia. He died at about 10pm. 2/13/09 Autopsy report received with COD Dilated and hypertrophic cardiomyopathy. DX: Left ventricular myocardial hypertrophy and dilitation, marked. Fatty alteration of the liver, moderate to marked. Bilateral hydroceles, R$gL. Pt seen 12/27/08 with c/o spitting up blood and sneezing. Dx with thrush and tx with Diflucan. Returned to PCP 12/29/08, impetigo noted and vax given. Returned 12/30/08 with c/o poor feeding, multiple watery, stringy stools, weakness and pallor. PE notable for grunting, poor color and decreased activity. Transported via EMS to hospital with concern for sepsis. T=96.8''F. HR=170''s. Severly dehydrated on arrival. Infant coded and expired.


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