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

Found 2,956 cases where Patient Died and Vaccination Date from '2010-01-01' to '2020-12-31'

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Case Details

This is page 26 out of 296

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VAERS ID: 455738 (history)  
Form: Version 1.0  
Age: 0.17  
Sex: Male  
Location: Virginia  
Vaccinated:2012-05-03
Onset:2012-05-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2012-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C4193AA / 1 LL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1522AA / 2 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH F51182 / 1 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1709AA / 1 MO / PO

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2012-05-04
   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
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Pt received vaccines on 5/3/12. Died on 5/4/12.


VAERS ID: 455795 (history)  
Form: Version 1.0  
Age: 0.19  
Sex: Female  
Location: Ohio  
Vaccinated:2012-05-14
Onset:2012-05-15
   Days after vaccination:1
Submitted: 2012-05-17
   Days after onset:2
Entered: 2012-05-18
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3753AA / 1 RL / UN
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0570AA / 2 LL / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 916617 / 1 LL / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1544AA / 1 MO / PO

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2012-05-15
   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: Nystatin
Current Illness: Thrush (mother states tx with Nystatin)
Preexisting Conditions: Per mother: Newborn screening showed Cystic Fibrosis Marker
Allergies:
Diagnostic Lab Data: Autopsy performed: results pending
CDC Split Type:

Write-up: None observed directly, within 30 min, after vaccine administration at the Health Dept. Mother notified Health Dept. on 5/17/2012 to report that her infant had expired at home in the early AM of 5/15/2012. She stated she called 911 when she determined her infant was unresponsive and that the Emergency Personnel had pronounced her "dead" on arrival.


VAERS ID: 456170 (history)  
Form: Version 1.0  
Age: 0.82  
Sex: Female  
Location: Washington  
Vaccinated:2012-05-09
Onset:2012-05-10
   Days after vaccination:1
Submitted: 2012-05-24
   Days after onset:14
Entered: 2012-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVC029CA / 3 RL / UN

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2012-05-10
   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: none
Current Illness: no
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Death.


VAERS ID: 456560 (history)  
Form: Version 1.0  
Age: 0.9  
Sex: Female  
Location: Unknown  
Vaccinated:2012-05-09
Onset:2012-05-09
   Days after vaccination:0
Submitted: 2012-05-30
   Days after onset:21
Entered: 2012-05-31
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Cyanosis, Death
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Hypotonic-hyporesponsive episode (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2012-05-09
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES1205USA04761

Write-up: Information has been received from a consumer concerning her 10 month old niece with no known allergies who on 09-MAY-2012 was vaccinated with a dose of RECOMBIVAX HB (dose, route and lot # not provided). The consumer stated that on 09-MAY-2012, the patient received the vaccine during the day and then went to sleep for a few hours and woke up at 7:00 pm that evening without any issues. The patient then went to sleep again at 10 pm followed by the mother discovering the baby later that night deceased at an unspecified time. The baby''s skin was blue in color when the mother discovered her indicating that the baby passed away. Additional information has been requested.


VAERS ID: 456644 (history)  
Form: Version 1.0  
Age: 0.51  
Sex: Male  
Location: New York  
Vaccinated:2012-05-24
Onset:2012-05-28
   Days after vaccination:4
Submitted: 2012-06-01
   Days after onset:4
Entered: 2012-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B305CA / 3 RL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. UH416AB / 3 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F65442 / 3 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1474AA / 3 MO / PO

Administered by: Private       Purchased by: Other
Symptoms: Abdominal X-ray, Abdominal mass, Abnormal behaviour, Apnoeic attack, Autopsy, Cardiac arrest, Death, Diarrhoea, Flatulence, Haematochezia, Intussusception, Irritability, Mechanical ventilation, Resuscitation, X-ray abnormal
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Dementia (broad), Pseudomembranous colitis (broad), Gastrointestinal obstruction (narrow), Gastrointestinal haemorrhage (narrow), Acute central respiratory depression (narrow), Psychosis and psychotic disorders (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Ischaemic colitis (broad), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Respiratory failure (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2012-05-29
   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: amoxicillin (started same day, not prior to vaccines)
Current Illness: Otitis media, cough
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: Xray: No focal pulmonary consolidation. Multiple prominent air filled bowel loops. No free air.
CDC Split Type:

Write-up: On 5/28/2012 began having diarrhea. On 5/29/12 am, he was a little fussy in the morning - mom gave gripe water and baby oragel. The babysitter called dad in the afternoon saying that the patient was not himself. When the dad picked him up he said the child was "out of it". Went to grandfathers house and called EMS. On EMS arrival patient had pulse in the 140''s and RR in the 30''s, by the time patient arrived at the ED patient was apneic and asystolic with bag valve mask ventilation being performed. Resusscitation was unsuccessful and the patient passed away. Upon attempt at a rectal temperature, bloody stool was noted in the diaper. There was also a palpable mass in the abdomen. The medical examiner confirmed the presence of intussusception on the autopsy.


VAERS ID: 457286 (history)  
Form: Version 1.0  
Age: 1.03  
Sex: Male  
Location: Massachusetts  
Vaccinated:2010-05-25
Onset:2010-06-13
   Days after vaccination:19
Submitted: 2012-06-12
   Days after onset:730
Entered: 2012-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH E47469 / 4 LL / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1233Y / 1 LL / SC

Administered by: Private       Purchased by: Unknown
Symptoms: Convulsion, Meningitis streptococcal
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2010-06-15
   Days after onset: 2
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fluoride drops 0.25mg qd
Current Illness: Upper respiratory infection, with a loose cough
Preexisting Conditions: Rash to Augmentin
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient developed seizures that were caused by streptococcal meningitis, 19A.


VAERS ID: 457319 (history)  
Form: Version 1.0  
Age: 7.0  
Sex: Female  
Location: Unknown  
Vaccinated:2011-12-01
Onset:2011-12-06
   Days after vaccination:5
Submitted: 2012-06-12
   Days after onset:188
Entered: 2012-06-13
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / UN

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2011-12-06
   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: 2012032567

Write-up: This social media report (initial receipt: 04-Jun-2012) concerns a 7-year-old female patient. On ??-Dec-2011 the patient received her fatal dose of flu vaccine (manufacturer, brand name and batch number were not reported) and was pronounced dead about 92 hours later on 06-Dec-2011. The cause of death was not reported.


VAERS ID: 457374 (history)  
Form: Version 1.0  
Age: 0.19  
Sex: Female  
Location: Kentucky  
Vaccinated:2012-05-16
Onset:2012-06-10
   Days after vaccination:25
Submitted: 2012-06-13
   Days after onset:3
Entered: 2012-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B326AA / 1 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UH428AB / 1 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F30921 / 1 RL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB268A / 1 MO / PO

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2012-06-10
   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: Viral gastroenteritis; diaper rash
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Infant died.


VAERS ID: 457526 (history)  
Form: Version 1.0  
Age: 54.0  
Sex: Male  
Location: Indiana  
Vaccinated:2012-05-02
Onset:2012-05-04
   Days after vaccination:2
Submitted: 2012-06-13
   Days after onset:40
Entered: 2012-06-15
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB538BA / 1 UN / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B079CA / UNK UN / IM
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI) / SANOFI PASTEUR G1130 / 1 UN / IM
YF: YELLOW FEVER (YF-VAX) / SANOFI PASTEUR UH284AA / 1 UN / SC

Administered by: Private       Purchased by: Private
Symptoms: Arthralgia, Death, Joint swelling, Muscle spasms, Myalgia, Sudden cardiac death
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Arrhythmia related investigations, signs and symptoms (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Dystonia (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2012-05-21
   Days after onset: 17
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: CRESTOR; PLAVIX; ASA; DIOVAN
Current Illness: None
Preexisting Conditions: Coronary Artery Disease; Hyperlipidemia; Hypertension
Allergies:
Diagnostic Lab Data: Cardiologist thought he had arrhythmic death.
CDC Split Type:

Write-up: Dr. experienced muscle aching and spasm on 4 May. He also had joint pain and swelling. This resolved by 9 May 12. He died in his sleep on 21 May 12.


VAERS ID: 457541 (history)  
Form: Version 1.0  
Age: 79.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2011-11-02
Onset:2011-11-05
   Days after vaccination:3
Submitted: 2012-06-13
   Days after onset:221
Entered: 2012-06-18
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLULAVAL) / GLAXOSMITHKLINE BIOLOGICALS AFLLA676AA / UNK AR / UN

Administered by: Private       Purchased by: Private
Symptoms: Cardiac failure congestive, Death, Dialysis, Immunosuppression, Mixed connective tissue disease, Neuropathy peripheral, Pneumonia primary atypical, Polymyositis, Renal failure
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Cardiac failure (narrow), Peripheral neuropathy (narrow), 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), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Chronic kidney disease (narrow), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2012-05-23
   Days after onset: 200
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 65 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: HTN; Arthritis
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Began with bilateral neuritis type symptoms both arms. Proceeded to "walking pneumonia", CHF polymyositis, mixed connective tissue disease, kidney failure & death. Tx- 2 inj of steroids, long term high dose steroids, immune suppression, dialysis & death.


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