National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 11/12/2021 release of VAERS data:

Found 2,947 cases where Patient Died and Vaccination Date from '2010-01-01' to '2020-12-31'

Government Disclaimer on use of this data



Case Details

This is page 20 out of 295

Result pages: prev   11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29   next


VAERS ID: 440529 (history)  
Form: Version 1.0  
Age: 57.0  
Sex: Male  
Location: Texas  
Vaccinated:2011-10-17
Onset:2011-10-18
   Days after vaccination:1
Submitted: 2011-10-28
   Days after onset:10
Entered: 2011-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLULAVAL) / GLAXOSMITHKLINE BIOLOGICALS AFLLA685AA / UNK RA / IM

Administered by: Other       Purchased by: Private
Symptoms: Death, Intensive care, Multi-organ failure, Septic shock
SMQs:, 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), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sepsis (narrow), Opportunistic infections (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2011-10-27
   Days after onset: 9
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: None.
Preexisting Conditions: Unknown.
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: Reported to us that patient received Flu shot on 10/17/2011 and went to ER. Admitted to ICU with septic shock and multiple organ failure.


VAERS ID: 440919 (history)  
Form: Version 1.0  
Age: 1.01  
Sex: Female  
Location: California  
Vaccinated:2011-10-10
Onset:2011-10-20
   Days after vaccination:10
Submitted: 2011-10-25
   Days after onset:5
Entered: 2011-11-01
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U4184BB / UNK RL / IM
HIBV: HIB (HIBERIX) / GLAXOSMITHKLINE BIOLOGICALS AHIBC291BA / UNK LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0047AA / 1 LL / SC
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 916922 / UNK RL / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0338AA / 1 RL / SC

Administered by: Private       Purchased by: Unknown
Symptoms: Asthenia, Brain herniation, Brain oedema, CSF test, Diarrhoea, Endotracheal intubation, Hydrocephalus, Posturing, Pyrexia, Rash, Unresponsive to stimuli, Ventricular cisternostomy, Viral test, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Dystonia (broad), Psychosis and psychotic disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hyponatraemia/SIADH (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Seckel syndrome or osteodysplastic primordial dwarfism
Allergies:
Diagnostic Lab Data: California encephalitis panel; CSF
CDC Split Type:

Write-up: Patient with likely osteodysplastic primary dwarfism began to have vomiting, diarrhea, rash, fever on 10/20, became progressively weaker. Seen in urgent care clinic 10/23, became very weak after home on BENADRYL, came to ER. Found to have hydrocephalus (more than previous MRI), decorticate posturing, intubated, ventriculostomy perform, no longer responsive, cerebral edema and herniation.


VAERS ID: 441165 (history)  
Form: Version 1.0  
Age: 95.0  
Sex: Female  
Location: Alabama  
Vaccinated:2011-09-22
Onset:2011-09-30
   Days after vaccination:8
Submitted: 2011-11-02
   Days after onset:33
Entered: 2011-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE) / SANOFI PASTEUR UH468AB / UNK LA / IM

Administered by: Private       Purchased by: Other
Symptoms: Aphasia, Asthenia, Encephalopathy, Fatigue, Gait disturbance, Hypersomnia, Nuclear magnetic resonance imaging brain abnormal, Weight decreased
SMQs:, Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Depression (excl suicide and self injury) (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2011-11-13
   Days after onset: 44
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Zinc; Vit D; MICARDIS; Levothyroxine; Vitamin C; PERICOLACE; MVI; Glucosamine; Calcium; PROTONIX
Current Illness: Reflux
Preexisting Conditions: Allergies: ALDOMET, VASOTEC, ZANTAC, MIRALAX, DEXILANT, Sulfa, Mycins; Hypertension; Arthritis; Stroke
Allergies:
Diagnostic Lab Data: MRI - head - possibility of encephalitis could be considered MD diagnosed: Acute post vaccine encephalopathy
CDC Split Type:

Write-up: Pt. admitted to hospital 10/27/11. About 4 wks prior had begun feeling weak, stumbling, fatigued. Has lost 15-20 pounds over past mo. Past 3-4 days family reported no verbal responses. Sleeping 16 or more hrs/day. Treated with Acyclovir IV.


VAERS ID: 441422 (history)  
Form: Version 1.0  
Age: 7.0  
Sex: Male  
Location: Texas  
Vaccinated:2011-10-17
Onset:2011-10-21
   Days after vaccination:4
Submitted: 2011-11-04
   Days after onset:14
Entered: 2011-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR UH455AD / 5 RA / IM

Administered by: Public       Purchased by: Other
Symptoms: Cardiac disorder, Condition aggravated, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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: UNKNOWN
Current Illness: DENIED
Preexisting Conditions: PER REPORTS CHILD HAD UNDISCLOSED HEART CONDITION
Allergies:
Diagnostic Lab Data: UNKNOWN
CDC Split Type: TX20110081

Write-up: PT WAS VACCINATED ON 10/17. NO DISTRESS IMMEDIATELY FOLLOWING VACCINATION. PER REPORT FROM SCHOOL NURSE, PT COLLAPSED ON PLAYGROUND ON 10/21. REPORTEDLY, CHILD HAD UNDISCLOSED HEART CONDITION.


VAERS ID: 441679 (history)  
Form: Version 1.0  
Age: 61.0  
Sex: Male  
Location: Virginia  
Vaccinated:2011-10-04
Onset:2011-10-11
   Days after vaccination:7
Submitted: 2011-11-07
   Days after onset:27
Entered: 2011-11-08
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR UT425AA / UNK UN / IM

Administered by: Public       Purchased by: Public
Symptoms: Abdominal distension, Adenovirus test, Alanine aminotransferase increased, Antibody test negative, Aspartate aminotransferase increased, Asthenia, Blood creatine phosphokinase MB increased, Blood creatine phosphokinase increased, Blood creatinine increased, Blood pH increased, Blood phosphorus increased, Borrelia test negative, Brain natriuretic peptide increased, C-reactive protein increased, Carbon dioxide decreased, Cardiac failure, Cardiomegaly, Chest X-ray abnormal, Chills, Cytomegalovirus test, Cytomegalovirus test negative, Death, Dialysis, Dyspnoea, Echocardiogram abnormal, Ejection fraction decreased, Epstein-Barr virus antibody positive, Extracorporeal membrane oxygenation, Fatigue, Feeling abnormal, Fibrin D dimer, General physical health deterioration, HIV test negative, Headache, Hepatitis B core antibody negative, Hepatitis B surface antibody negative, Hepatitis B surface antigen negative, Hepatitis C antibody negative, Influenza, Influenza A virus test negative, Influenza B virus test, Intensive care, Jaundice, Left ventricular dysfunction, Lung consolidation, Myalgia, Myocarditis, Neutrophil percentage increased, PO2 decreased, Pericardial effusion, Pleural effusion, Protein urine present, Pulmonary arterial pressure normal, Pulmonary hypertension, Pulmonary oedema, Red blood cell sedimentation rate increased, Renal impairment, Respiratory syncytial virus test negative, Streptococcus test negative, Toxoplasma serology, Toxoplasma serology negative, Troponin I increased, Ventricular assist device insertion, Weight increased, White blood cell count increased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Cardiac failure (narrow), Liver related investigations, signs and symptoms (narrow), Cholestasis and jaundice of hepatic origin (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (narrow), Myocardial infarction (narrow), Retroperitoneal fibrosis (broad), Dementia (broad), Acute central respiratory depression (broad), Biliary system related investigations, signs and symptoms (narrow), Biliary tract disorders (narrow), Pulmonary hypertension (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (narrow), Eosinophilic pneumonia (broad), Chronic kidney disease (narrow), Tumour lysis syndrome (narrow), Proteinuria (narrow), Tubulointerstitial diseases (broad), Respiratory failure (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2011-10-27
   Days after onset: 16
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 12 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: ASACOL; omega 3s; mvi
Current Illness: Ulcerative colitis well controlled and asymptomatic at the time
Preexisting Conditions: Ulcerative colitis; mild glaucoma
Allergies:
Diagnostic Lab Data: CRP, 25.92 (15 Oct); ESR, 79; 18 Oct labs: WBC, 24.4/87 neuts; Troponin I 12.40; BNP, 55321; CKMB, 63.8; CK, 501; ALT/AST, 2587/3549; creatinine, 2.7; phosphate, 7.9; ABG pH/ PO2CO2, 7.48/63/16.1; Antibody panels: Epstein-Barr virus nuclear Ab IgG serum, $g5.00; Epstein -Barr virus capsid Ab IgG serum, 2.7; Epstein-Barr virus capsid Ab IgM serum, <0.2; Epstein-Barr virus nuclear Ab IgG, $g8.0; Hepatitis B virus surface Ab serum Non reactive; Hepatitis B virus surface Ag serum Non reactive; Hepatitis B virus Core Ab IgM serum Non Reactive; Hepatitis C virus Ab serum Non reactive; nasopharyngeal swab 21 Oct: NO INFLUENZAE A/B, PARAINFLUENZA 1-3, adenovirus, or RSV isolated; HIV negative; Cytomegalovirus Ab IGG/IGM negative; Toxoplasma Ab IGG/IGM negative; Streptolysin O Ab negative; Lyme disease total ab screen negative; ECHO 18 Oct, - overall left ventricular systolic function severely reduced EF < 20%, - small circumferential pericardial effusion present, -mild pulm hypertension w/PA systolic pressure estimated at 40mmHg, - No cardiac tamponade, left ventricular wall thickness normal, LV cavity dimensions normal; CXR as above
CDC Split Type:

Write-up: 61 y/o stated he received injectable INFLUENZA vaccine on 4 Oct 2011. States he has received the flu shot every year with no problems as well as no adverse events with any other vaccinations in his career. PMH includes ulcerative colitis for which he took ASACOL. He developed this condition in the late ''90''s and it has been under good control with no active symptoms. Took ASACOL up until the time of hospitalization but was not given it after admitted. Pt was healthy and active, worked full time and ran 3-4 miles 5x/week and ran the 10 miler on Sunday 9 Oct''11. On Tues, 11 Oct he developed chills in the evening. He went to work the next day but by evening "wasnt feeling right". He stayed home from work on Thurs 13 Oct with chills, myalgias, headache, abdominal bloating and weakness. Denied having chest pain, fever, cough, sob. He got weighed and found he had gained 7 pounds. He continues to feel badly and went into primary care on Fri, 14 Oct where exam was normal, was diagnosed with the flu and was sent home with conservative tx. He went to the ER on Sat 15 Oct when he continued to feel worse: WBC 18 Neutrophils Troponin 3.6 (continuing to rise to current 8.24, BNP 38747, ALT 209, AST 147, CKMB 34.8. He was admitted to CCU with diagnosis of myocarditis with cardiac failure. Labs as of 18 Oct at hospital: creatinine 1.8, D-dimer 2.15, urine protein SSA positive, influenza A & B virus antigen negative via nasopharyngeal swab. Pt was SOB, slightly jaundiced, c/o bloating in abdomen and fatigued. P 94, 113/64 CXR shows enlarged cardiacmediastinal silhouette with bilat pul, consolidations. CXR had evolved to develop pleural effusion, clear evidence of pulmonary edema, and continued cardiomegaly. INPT treatment: LOPRESSOR, NEXIUM, PLAVIX, TAMIFLU, LASIX, O2, piperacillin/tazobactam. Transferred to another hospital on 18 Oct not only to receive dialysis due to worsening renal function, but also due to potential need for ECMO (extra-corporeal membrane oxygenation) as a bridge to LVAD (Left ventricular assist device). Update 21 Oct: pt continued to worsen, on ECMO, receiving steroids, unable to do heart biopsy due to worsening condition. Biventricular assist device inserted on 25 Oct at hospital. Patient died on 27 Oct. Titers/PCR pending on myocardial tissue. Path report returned yesterday showed giant cell myocarditis, no eosinophils. Additional labs pending from hospital to include parvo and coxackie abs.


VAERS ID: 442054 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Male  
Location: Missouri  
Vaccinated:2011-10-17
Onset:2011-10-18
   Days after vaccination:1
Submitted: 2011-11-10
   Days after onset:23
Entered: 2011-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B285EA / 1 LL / IJ
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UH321AA / 1 RL / IJ
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 916972 / 1 RL / IJ
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS 41CB098A / 1 MO / PO

Administered by: Military       Purchased by: Military
Symptoms: Crying, Cyanosis, Death, Musculoskeletal stiffness, Peripheral coldness, Respiratory arrest
SMQs:, Anaphylactic reaction (broad), Dystonia (broad), Parkinson-like events (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Arthritis (broad), Respiratory failure (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2011-10-18
   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: No illness at the time. Patient was crying after his shots, that was the only reaction he showed. No fevers all day. He went to sleep at his normal time. Woke up around 0230 am and my husband rocked him back to sleep. When my husband went to wake patient up, patient wasn''t breathing, he was blue in the lips and cold and stiff. He was pronounced dead at 0604 am on 10/18/2011.
Preexisting Conditions: n/a
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Death


VAERS ID: 442402 (history)  
Form: Version 1.0  
Age: 15.0  
Sex: Male  
Location: Oregon  
Vaccinated:2011-10-17
Onset:2011-10-17
   Days after vaccination:0
Submitted: 2011-11-14
   Days after onset:28
Entered: 2011-11-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1262AA / UNK RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U4006AA / UNK RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B072EA / UNK RA / IM

Administered by: Private       Purchased by: Public
Symptoms: Death, Pain, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2011-10-20
   Days after onset: 3
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Depakote, Lyrica, Diazapam, Adderall
Current Illness: No
Preexisting Conditions: Seizure Disorder
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Initial soreness and swelling. Death 10/20/2011.


VAERS ID: 443115 (history)  
Form: Version 1.0  
Age: 11.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2011-10-06
Onset:2011-10-28
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2011-11-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0675AA / 2 RA / UN

Administered by: Public       Purchased by: Public
Symptoms: Death, Diarrhoea, Escherichia infection
SMQs:, Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Infective pneumonia (broad), Opportunistic infections (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2011-11-02
   Days after onset: 5
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: DEPAKOTE
Current Illness: None
Preexisting Conditions: Trisomy 21; epilepsy
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Diarrheal illness on 10/28/11 - transferred to hospital on 10/31/11. Died on 11/2/11 - dx with E-coli 0157 Huhs. She was Trisomy 21 (Downs) & epilepsy, well controlled with med.


VAERS ID: 443712 (history)  
Form: Version 1.0  
Age: 18.0  
Sex: Male  
Location: Washington  
Vaccinated:2011-11-15
Onset:2011-11-23
   Days after vaccination:8
Submitted: 2011-11-28
   Days after onset:5
Entered: 2011-11-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ANTH: ANTHRAX (BIOTHRAX) / EMERGENT BIOSOLUTIONS FAV294 / 1 UN / UN
SMALL: SMALLPOX (ACAM2000) / SANOFI PASTEUR VV040003A / 1 UN / -
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI) / SANOFI PASTEUR B1026 / 1 UN / UN

Administered by: Military       Purchased by: Military
Symptoms: Activated partial thromboplastin time prolonged, Blood creatine phosphokinase increased, Blood creatinine increased, Blood fibrinogen decreased, Body temperature increased, Cardioversion, Disseminated intravascular coagulation, Encephalopathy, Hepatic enzyme increased, Intensive care, Leukocytosis, Loss of consciousness, Pain, Prothrombin time prolonged, Renal failure, Rhabdomyolysis, Thrombocytosis, Troponin I increased
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (narrow), Acute renal failure (narrow), Liver related investigations, signs and symptoms (narrow), Liver-related coagulation and bleeding disturbances (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (narrow), Myocardial infarction (narrow), 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 (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Chronic kidney disease (narrow), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2011-11-28
   Days after onset: 5
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None listed and all AHLTA meds not active. Was given doxycycline for malaria prophylaxis on SRP note--but would not have taken it until 2 days prior to deployment.
Current Illness: None recorded
Preexisting Conditions: allergy to primaquine and G6PD deficient
Allergies:
Diagnostic Lab Data: Leukocytosis, thrombocytosis, decreased fibrinogen and prolonged PT/PTT, elevated liver enzymes, Increased Cr, Increased CKs, transient elevated TNIs
CDC Split Type:

Write-up: Per records, patient was in 5 mile run and passed out--HR$g180s and T~102.9 - adenosine and cardioversion with IVF-admitted to ICU-placed on broad spectrum Abx and Cx drawn. Progressive, rhabdomyolysis, DIC, renal failure, pain, and encephalopthy. Tx with cryo, ffp, fluids, pressors and ultimately transferred to another facility.


VAERS ID: 443738 (history)  
Form: Version 1.0  
Age: 0.17  
Sex: Male  
Location: Missouri  
Vaccinated:2011-11-18
Onset:2011-11-26
   Days after vaccination:8
Submitted: 2011-11-28
   Days after onset:2
Entered: 2011-11-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B315AA / 1 LL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0487AA / 1 LL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 916976 / 1 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0919AA / 1 MO / PO

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2011-11-26
   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: eye drops
Current Illness: None (resolving conjunctivitis)
Preexisting Conditions: ? laryngomalacia
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Died of apparent SIDS.


Result pages: prev   11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29   next

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?EVENTS=ON&PAGENO=20&DIED=Yes&VAX_YEAR_LOW=2010&VAX_MONTH_LOW=01&VAX_YEAR_HIGH=2020&VAX_MONTH_HIGH=12


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