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From the 1/14/2022 release of VAERS data:

Found 3,130 cases where Patient Died and Vaccination Date from '2007-08-01' to '2020-11-30'

Government Disclaimer on use of this data



Case Details

This is page 27 out of 313

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VAERS ID: 354571 (history)  
Form: Version 1.0  
Age: 1.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2009-05-30
Onset:2009-06-01
   Days after vaccination:2
Submitted: 2009-08-18
   Days after onset:78
Entered: 2009-08-19
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0932X / 1 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH C68309 / 4 LL / IM

Administered by: Private       Purchased by: Other
Symptoms: Blood culture positive, CSF culture positive, Cerebrovascular accident, Condition aggravated, Death, Discomfort, Eye disorder, Irritability, Meningitis pneumococcal, Pneumococcal sepsis, Pyrexia, Streptococcus identification test positive, Upper respiratory tract infection, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Corneal disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Sepsis (narrow), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2009-06-23
   Days after onset: 22
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: Concomitant medications were not reported.
Current Illness: Unknown 9/1/09-records received-Upper respiratory viral infection 2 weeks prior to admission.
Preexisting Conditions: The patient has a past history of wheezing (during the winter of 2008-2009 and 09-Jun-2009 to 13-Jun-2009). The child''s age appropriate immunization schedule included: Diphtheria/Tetanus Toxoids/Acellular Pertussis Vaccine, Hepatitis B Vaccine, Haemophilus Influenzae B and IPOL. Per the treating physician the patient attended daycare and the patient had no significant medical history. 8/24/09 Hospital records received DOS 6/21/09 to 6/23/09. Cough. Wheezing.
Allergies:
Diagnostic Lab Data: CSF culture (results: Positive for Streptococcus pneumoniae) and blood culture (results: Positive for Streptococcus pneumoniae) were done in Jun-2009. 8/24/09 Hospital records received DOS 6/21/09 to 6/23/09. LABS and DIAGNOSTICS: Urinalysis - Dark Yellow, Ketone 80, Protein 300, RBC Many /hpf, Bacteria Many /hpf, Hyaline Cast 10-20 /hpf. Basic Metabolic Profile - CO2 19 mmol/L (L) Glucose 118 mg/dl (H) Phosphorus 2.5 mg/dl (L). CBC - RBC 3.93 /pL (L) HGB 10.6 g/dl (L) HCT 32.3% (L) RDW CV 16% (H) Platelet 24 /nL (L) Monocytes 3.0% (L) Bands 20% (H) Lymphocytes Abs 2.8 (L). Prothrombin Time 20.2 sec (H) Activated PTT 42.8 sec (H) Fibrinogen 539 mg/dl (H). C-Reactive Protein 315.2 mg/L (H). Sed Rate 100 mm/hr (H). Spinal Tap / CSF - Turbid, WBC 167 /UL (H), RBC 15 /UL (H) Lymphocytes 25% (L), glucose <1 mg/dl (L), Total Protein 474 mg/dl (H), gram stain Gram positive cocci, culture Strep pneumoniae. Blood culture - gram positive cocci, Strep pneumoniae. Urine culture - no growth. Vancomycin Trough 57.7 ug/ml (H). Blood gases abnormal. Negative Viral tests.
CDC Split Type: USWYEH10544309

Write-up: Information regarding PREVNAR was received from a healthcare professional regarding a 12-month-old male patient who experienced pneumococcal meningitis, pneumococcal sepsis, upper respiratory infection and stroke. The patient received the fourth dose on 30-May-2009. The patient also received the first dose of VAQTA (Merck) on 30-May-2009. During the winter of 2008-2009 the patient experienced wheezing, treatment unknown. On 09-Jun-2009 the patient was seen in the office with wheezing treated with ORAPRED in addition to PULMICORT and Albuterol inhalation therapy. On 13-Jun-2009 follow-up showed the wheezing resolved. On 20-Jun-2009 the patient presented to the physician with a two day history of fever, fussiness and being uncomfortable per the parents. In the office the child engaged with the staff and was playful. He was afebrile with no cough noted and was diagnosed with an upper respiratory infection, treatment unknown. On 21-Jun-2009 the parents telephoned the office and "seemed nervous which was not normal for them". The physician examined the child and noticed a drooping eye, side unknown, and was diagnosed with stroke. This event was considered medically important. The child was admitted to the local hospital and on an unknown date was transported to another hospital. On 23-Jun-2009 the child died. The cause of death was reported as meningitis pneumococcal and pneumococcal sepsis. Serotype testing was not performed at the time of this report but is being requested by the child''s physician. No additional information was available at this time of this report. 8/24/09 Hospital records received DOS 6/21/09 to 6/23/09. Assessment: Fever. meningitis. Patient earlier this day presented at ED with fever. Seen later for drooping and swelling of right eyelid and vomiting after Advil. Moderate distressed, photophobia, fussiness. Not alert, moaning, hypotonic. 9/1/09-records received for 6/23/09-COD-Pneumococcal meningitis, septic shock, acute respiratory distress syndrome, multiorgan failure, left hemispheric infarct. Transferred from another facility after presenting with febrile illness, progressive lethargy and poor feeding and worsening respiratory distress. Developed respiratory failure intubation and ventilator support, developed shock, multiorgan failure.


VAERS ID: 355056 (history)  
Form: Version 1.0  
Age: 50.0  
Sex: Male  
Location: Florida  
Vaccinated:2009-01-25
Onset:2009-01-25
   Days after vaccination:0
Submitted: 2009-08-24
   Days after onset:210
Entered: 2009-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. UNKNOWN / UNK RA / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Anaphylactic reaction, Anaphylactic shock, Immediate post-injection reaction
SMQs:, Anaphylactic reaction (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2009-01-25
   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: List includes PRN meds / standing orders over one month hospital stay:Tylenol PO, Norvasc PO, Bisacodyl PO,chlorpromazine IM, clonidine PO, Cardene IV, fentanyl IV, haldol IM, Primaxin IV, hydralazine IV, labetolol IV, levaquin IV, Ativan I
Current Illness: anaphylaxis (immediate)
Preexisting Conditions: Allergy to ace inhibitors (swollen lips, a sign of angioedema). PMH of hypertension x 14 years.
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: anaphylaxis (immediate) 9/10/09 Received hospital medical records of 12/2/08-1/24/2009. FINAL DX: Expired; malignant neoplasm of kidney; pulmonary insufficiency; HTN; hypertensive urgency; pulmonary atelectasis; acute pancreatitis; paralytic ileus; bacteremia; peritoneal abscess; pure hypercholesterolemia; GERD; anxiety; cardiac dysrhythmia; anemia; leukocytosis; psychosis; gastroparesis; hematuria; hypertensive chronic kidney disease Records reveal patient experienced progressively increasing abdominal pain & swelling x 11 mo. Nephrology, Uro, Heme/Onc, gen surgery, Cardio, Pulm, ID consults done. Taken to 12/19 OR for exp lap, radical left nephrectomy, jejunostomy & appendectomy. Developed post op HTN, fever, pancreatitis, ileus, psychosis & OBS. Taken back to OR for re-exploration of bowel obstruction requiring bowel resection & removal of massive adhesions, abdominal wound left open. Chest tube & thoracotomy. Progressed slowly & was ready for d/c to home when he received the vaccine. Patient developed immediate respiratory difficulty, had a seizure & respiratory-cardiac arrest & was unable to be resuscitated. ME refused autopsy but was done in hospital


VAERS ID: 355131 (history)  
Form: Version 1.0  
Age: 0.34  
Sex: Female  
Location: Washington  
Vaccinated:2009-08-11
Onset:2009-08-14
   Days after vaccination:3
Submitted: 2009-08-21
   Days after onset:7
Entered: 2009-08-25
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3297AA / 1 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH D39015 / 2 RL / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2009-08-14
   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: ZANTAC
Current Illness: None
Preexisting Conditions: GERD
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt found dead in crib on 8/14/09. Preliminary autopsy showed no cause of death. 12/29/2009 Autopsy report received. Cause of Death: Sudden Unexplained Infant Death. Additional information abstracted: History of prone sleep position, Intrathoracic petechia (pleural and thymus involvement). Toxicology: acetaminophen (+), carbon monoxide <5 % Sat. Skeletal Survey - Hypoventilatory chest.


VAERS ID: 355219 (history)  
Form: Version 1.0  
Age:   
Sex: Female  
Location: Texas  
Vaccinated:2009-03-25
Onset:2009-03-31
   Days after vaccination:6
Submitted: 2009-08-25
   Days after onset:147
Entered: 2009-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Autopsy, Death, Diet refusal, Eosinophilic myocarditis, Feeling cold, Histology, Irritability, Jaundice neonatal, Unresponsive to stimuli, Vomiting
SMQs:, Congenital, familial, neonatal and genetic disorders of the liver (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Congenital biliary disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Cardiomyopathy (narrow), Neonatal disorders (narrow), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2009-04-01
   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:
Current Illness: None
Preexisting Conditions: None, maybe jaundice several days after birth
Allergies:
Diagnostic Lab Data: none besides the histology of the heart.
CDC Split Type:

Write-up: Decedent is a 7 day old neonate who was given the hepatitis B immunization at birth (Energix B). Lot # AHBVB663AA. Decedent discharged on March 27, 2009 without complications. On March 30, 2009 decedent was taken to pediatrician mild jaundice. Labs taken and was told to come back in two weeks. In the evening of March 31, 2009, the decedent was very fussy, vomiting, and not taking formula. The mother tried comforting the baby all evening of March 31, 2009 and in the early morning hours of April 1, 2009. At approximately 6 AM, the mother felt the baby to be cold (the mother was sleeping with the baby in a possibly compromising position). The mother got up with the baby and walked her around and then when she was going to bed again, she saw the neonate take two deep breaths and become unresponsive. Autopsy revealed a normally developed female neonate with extensive necrotizing eosinophilic myocarditis. I did a literature search and found that hepatitis B vaccine maybe associated with this type of myocarditis and that is why I am reporting it. The cause of death for the death certificate reads "necrotizing eosinophilic myocarditis." I am not including the vaccination because I do not believe there is a direct correlation, but I felt I should report the case for potential correlation. The neonate was never given any prescription medications that I am aware of. Not sure if mother gave anything. 8/26/09-autopsy report received-COD-Necrotizing eosinophilic myocarditis.


VAERS ID: 355396 (history)  
Form: Version 1.0  
Age: 63.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2008-09-09
Onset:2008-10-01
   Days after vaccination:22
Submitted: 2009-08-25
   Days after onset:328
Entered: 2009-08-26
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLULAVAL) / GLAXOSMITHKLINE BIOLOGICALS AFLLA155AA / 1 UN / UN

Administered by: Private       Purchased by: Public
Symptoms: Cardiac failure, Death, Hypoaesthesia, Intensive care, Mobility decreased, Muscular weakness, Pain in extremity, Paralysis, Wheelchair user
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (narrow), Peripheral neuropathy (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2008-10-21
   Days after onset: 20
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 17 days
   Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: FLOMAX; ASPIRIN; LOPID; TORSEMIDE; LYRICA; QUINAPRIL; DIOVAN; ZOCOR; CLONIDINE; ZEMPLAR; HUMULIN; Fish oil; Calcium
Current Illness: Diabetes; Renal failure
Preexisting Conditions: Diabetes; Diabetic neuropathy; Renal disease; Stroke. 9/11/09 Hospital records received DOS 10/6/08 to 10/21/08. Known history of recent myocardial infarction. Type 2 Diabetes Mellitus. Diabetic neuropathy and retinopathy. Diabetic nephropathy. Hyperlipidemia. Bilateral ankle surgery. Immobility. History of lumbar degenerative disk disease. Hypertension.
Allergies:
Diagnostic Lab Data: See med. records - too numerous. 9/11/09 Hospital records received DOS 10/6/08 to 10/21/08. LABS and DIAGNOSTICS: CD4/CD8 Ratio - Normal. CSF Oligoclonal Bands (IEF) - Total Protein 133 mg/dL (H) IgG 11.20 mg/dL (H) Albumin 77.7 mg/dL (H) Synthesis Rate 11.3 (H). Serum - IgG 558 mg/dL (L) Albumin 2200 mg/dL (L). No evidence of IgG bands in CSF or serum. CSF - Glucose 94 mg/dL (H) Sodium 146 mmol/L (H) Potassium 5.1 mmol/L (H). CHEM - Potassium 7.5 mmol/L (H) Chloride 113 mmol/L (H) BUN 104 mg/dL (H) Creatinine 3.84 mg/dL (H) Glucose 247 mg/dL (H) ALKPHOS 525 U/L (H) ALT 901 U/L (H) AST 3348 U/L (H) Amylase 191 U/L (H) Bilirubin Direct 1.0 mg/dL (H) LDH 560 U/L (H) Phos 14.1 mg/dL (H) SGGT 189 U/L (H) Uric Acid 9.5 mg/dL (H) CK 73311 U/L (H) CKMB 172.4 ng/mL (H) Troponin 6.38 ng/mL (H). CRP 24.27 mg d/L (H). D-DMR $g1000 ng/mL (H). PT 23.6 drc (H). Parathroid PTH 426.2 pg/mL (H). Thyroid Profile abnormal. HGB A1C 8.2% (H). CBC - HGB 7.4 g/dL (L) HCT 22.5% (L) RBC 2.51 M/mm3 (L) RDW 18.5% (H) Platelets 143 Thou/mm3 (L) Neut 13.7 Thou/mm3 (H) WBC 22.0 Thou/mm3 (H) Sed Rate 110 mm/HR (H). Culture (R) foot - Positive Coagulase Negative Staph. Fecal Occult Blood (+). Urinalysis - Orange, Turbid, Sp Grav 1.033 (H), Protein (+) Glucose (+) Acetone (+) Occult Blood (+) WBC (+) RBC (+) Renal Epith (+). Segnmental BP LE - Abnormal.
CDC Split Type:

Write-up: On 10-01-08 he complained of soreness and unusual weakness and numbness in legs (after physical therapy). Had to have help to & from wheelchair and bed. Much worse Thur, Fri. By Sat. he could not move on his own from chest down. Convinced him to go to ER on Sunday. Paralyzed by PM 10-05-08. Transferred to hospital 10-05-08, put in ICU AM 10-06-08. Code blue (heart failure 10-10-08). See med. reports (Also I kept diary) too numerous. 9/11/09 Hospital records received DOS 10/6/08 to 10/21/08. Assessment: Cardiorespiratory failure. Advanced Guillain-Barre Syndrome. Chronic renal disease with initiation of hemodialysis. Type 2 Diabetes Mellitus with increased rhabdomyolysis. Episode of supraventricular tachycardia. Episode of cardiac arrhythmia. Probable sepsis. Patient transfered to facility after noticing weakness in upper and lower extremity. Plasmapheresus. Renal functioning worsened. Flaccid. Pneumonia. Extubated per patient''s desire. Quickly expired. 10/5/09 Death Cert received with COD=Cardiorespiratory Failure due to End Stage Renal Disease due to Guillain-Barre Syndrome


VAERS ID: 356434 (history)  
Form: Version 1.0  
Age: 0.17  
Sex: Male  
Location: Kentucky  
Vaccinated:2009-07-15
Onset:2009-08-09
   Days after vaccination:25
Submitted: 2009-09-03
   Days after onset:25
Entered: 2009-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B177CA / 1 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF569AA / 1 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH D39016 / 1 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0571Y / 1 MO / PO

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2009-08-09
   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: none
Current Illness: none
Preexisting Conditions: reflux
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: No known adverse reactions. Aunt reports infant died of SIDS on 8/9/09. 12/29/09 Autopsy report received. DOD 8/09/09. Cause of Death: Consistent with Sudden Unexplained Death in Infancy. Additional Information Abstracted: A. Co-sleeping male infant with parental caregivers. B. Petechia of heart. C. Pulmonary edema. D. No evidence of congenical anomaly. E. No evidence of trauma. F. Postmortem toxicological screen of the postmortem blood negative for drugs and ethanol. II. History of Colic and Thrush per family. A No gross lesions of mouth. III. Therapeutic Procedures. A. Endotracheal intubation. B. Intravascular and intraosseus catheters.


VAERS ID: 356473 (history)  
Form: Version 1.0  
Age: 0.7  
Sex: Female  
Location: Washington  
Vaccinated:2009-07-07
Onset:2009-07-09
   Days after vaccination:2
Submitted: 2009-09-03
   Days after onset:56
Entered: 2009-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3280AA / 3 LL / IM
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBNB663AA / 3 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH D36147 / 3 RL / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2009-07-09
   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: Prevacid; Tylenol
Current Illness: None
Preexisting Conditions: Failure to thrive; GE Reflux; Ht. murmur; Pre-maturity. 9/11/09 Autopsy received DOD 07/09/2009. Born at 37-38 weeks gestational age, small for gestational age.
Allergies:
Diagnostic Lab Data: Autopsy was performed. 9/11/09 Autopsy received DOD 07/09/2009. LABS and DIAGNOSTICS: Negative Radiographic Skeletal Survey. Toxicology Blood - Ethanol (-) No Drugs Detected.
CDC Split Type:

Write-up: Death. 9/11/09 Autopsy received DOD 07/09/2009. Sudden Unexplained Death in Infancy (SUIDI or SIDS). The manner of death is natural. Additional information abstracted: Infant was found dead in crib, positioned supine. No evidence of injury.


VAERS ID: 356603 (history)  
Form: Version 1.0  
Age: 66.0  
Sex: Female  
Location: North Dakota  
Vaccinated:2009-06-22
Onset:2009-06-23
   Days after vaccination:1
Submitted: 2009-09-04
   Days after onset:73
Entered: 2009-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
TDAP: TDAP (ADACEL) / SANOFI PASTEUR UF484BA / UNK UN / IM

Administered by: Private       Purchased by: Private
Symptoms: Biopsy lung, Cardiac stress test, Catheterisation cardiac, Computerised tomogram, Death, Dyspnoea, Pulmonary embolism, Pulmonary function test, Right ventricular failure
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2009-08-19
   Days after onset: 57
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: ASACOL; Calcium; Vitamin D; Aspirin
Current Illness: Primary sclerosing cholangitis
Preexisting Conditions: None.
Allergies:
Diagnostic Lab Data: Cardiolyte stress test; chest CT scan; pulmonary function testing; heart catheterization; open lung biopsy.
CDC Split Type:

Write-up: Shortness of breath, initially with exertion. Progressive to dyspnea at rest, pulmonary emboli, right heart failure.


VAERS ID: 356938 (history)  
Form: Version 1.0  
Age: 19.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2008-07-21
Onset:2008-09-12
   Days after vaccination:53
Submitted: 2009-09-10
   Days after onset:363
Entered: 2009-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 17400 / 3 LA / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Chest pain, Death, Dizziness, Dyspnoea, Fatigue, Feeling cold, Headache, Muscle spasms, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Dystonia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2008-09-12
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: None~ ()~~0.00~Patient
Other Medications: Yaz until 3/17/08. Femcon beginning 3/17/08. Anaprox as needed.
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None. I do have copies of all medical history from 01/08/2004 to the time of her death that I can provide if needed. The Medical Examiners office will have tissue samples until 4/2010.
CDC Split Type:

Write-up: Headache, Nausea, dizziness, chilling, tiredness, shortness of breath, complained of chest plain, severe cramps. 9/14/09 Received vaccine & PCP medical records which reveal patient seen 12/5/07 & 2/27/08 with sore throat, fever, chills, fatigue, body aches, productive cough w/yellow sputum & HA. Dx both times w/acute bronchitis & tx w/antibiotics & cough syrup. 9/25/09 Autopsy report received DOD 09/12/2008. Acute Cardiac Arrhythmia of Unknown Etiology. Addtional information abstracted: Heart with focal microscopic ischemic changes, pulmonary congestion and edema. Rare petechiae: conjunctival, periorbital and laryngeal. Resuscitation related sternal fracture.


VAERS ID: 357588 (history)  
Form: Version 1.0  
Age: 0.46  
Sex: Male  
Location: Virginia  
Vaccinated:2009-09-01
Onset:2009-09-08
   Days after vaccination:7
Submitted: 2009-09-11
   Days after onset:3
Entered: 2009-09-17
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVB780AA / 2 RL / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0175Y / 1 MO / PO

Administered by: Private       Purchased by: Public
Symptoms: Apnoea, Death
SMQs:, Acute central respiratory depression (narrow), Respiratory failure (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2009-09-08
   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: Spironolactone; Levothyroxine; Chlorothiazide; FeSO4; NaCl; O2
Current Illness: BPD = Hypothyroid:Prematurity
Preexisting Conditions: Hyponatremia
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: NICU graduate (24 5/7 wks) gestation) Brought to office apneic 9/08/09 CPR unsuccessful. Chron. age about 6 mos DOB 3/17/09.


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https://medalerts.org/vaersdb/findfield.php?EVENTS=ON&PAGENO=27&DIED=Yes&VAX_YEAR_LOW=2007&VAX_MONTH_LOW=08&VAX_YEAR_HIGH=2020&VAX_MONTH_HIGH=11


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