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

Found 2,964 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 29 out of 297

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VAERS ID: 464200 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Male  
Location: Iowa  
Vaccinated:2011-07-25
Onset:2011-07-25
   Days after vaccination:0
Submitted: 2012-08-30
   Days after onset:402
Entered: 2012-09-06
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3895AA / UNK RL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0732Z / UNK RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 916006 / UNK RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0708Z / UNK MO / PO

Administered by: Private       Purchased by: Unknown
Symptoms: Constipation, Cough, Crying, Death, Decreased appetite, Irritability, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Depression (excl suicide and self injury) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2011-08-11
   Days after onset: 17
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Allergies.~Vaccine not specified (no brand name)~1~0.00~Sibling|Respiratory vomiting issues.~Vaccine not specified (no brand nam
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Cough, fussiness, fever, persistent crying, lack of appetite, cough, constipation, death.


VAERS ID: 465397 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Female  
Location: Missouri  
Vaccinated:2012-08-15
Onset:2012-08-16
   Days after vaccination:1
Submitted: 2012-09-04
   Days after onset:19
Entered: 2012-09-18
   Days after submission:14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B33CE / 1 LL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0221AE / 1 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 918242 / 1 RL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB288A / 1 MO / PO

Administered by: Private       Purchased by: Public
Symptoms: Cardio-respiratory arrest, Death, Respiratory arrest, Resuscitation
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Respiratory failure (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2012-08-16
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Oral NaCl
Current Illness: Nasal congestion
Preexisting Conditions: Pre-term birth; Hyponatremia
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient found at home not breathing, CPR started. EMS continued CPR & brought patient to our ED. Patient still in full cardiopulmonary arrest. Patient never recovered heart rate.


VAERS ID: 465434 (history)  
Form: Version 1.0  
Age: 0.15  
Sex: Male  
Location: Indiana  
Vaccinated:2012-09-14
Onset:2012-09-15
   Days after vaccination:1
Submitted: 2012-09-18
   Days after onset:3
Entered: 2012-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B330CE / 1 LL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0419AE / 1 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 918246 / 1 RL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB288A / 1 MO / PO

Administered by: Public       Purchased by: Public
Symptoms: 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: 2012-09-15
   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:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Child received vaccines on 9/14/12. Parent reported found child unresponsive on 9/15/12. Taken by ambulance to ER and pronounced.


VAERS ID: 465543 (history)  
Form: Version 1.0  
Age: 86.0  
Sex: Female  
Location: Florida  
Vaccinated:2012-08-18
Onset:2012-08-18
   Days after vaccination:0
Submitted: 2012-09-11
   Days after onset:24
Entered: 2012-09-19
   Days after submission:8
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER LIVE (ZOSTAVAX) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Unknown       Purchased by: Unknown
Symptoms: Asthenia, Cardiac disorder, Death, Dyspnoea, Gait disturbance, Pain
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2012-08-22
   Days after onset: 4
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Heart Dr. did not want to see us in 6 months several days earlier.
Allergies:
Diagnostic Lab Data: Coroner assumed it was massive heart failure
CDC Split Type:

Write-up: Severe weakness, severe pain, difficulty breathing. Pain meds, heart meds, aspirin, TYLENOL. Could not walk without assistance.


VAERS ID: 465858 (history)  
Form: Version 1.0  
Age: 0.62  
Sex: Female  
Location: North Carolina  
Vaccinated:2012-08-28
Onset:2012-08-30
   Days after vaccination:2
Submitted: 2012-09-14
   Days after onset:15
Entered: 2012-09-21
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C4186AA / 3 LL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0293AE / 3 RL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0130AE / 3 RL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR H1330 / 3 LL / SC
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F63665 / 3 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0033AE / 3 MO / PO

Administered by: Private       Purchased by: Public
Symptoms: Apnoeic attack, Autopsy, Brain death, Cyanosis, Death, Hypoxic-ischaemic encephalopathy, Intensive care, Multi-organ failure, Unresponsive to stimuli
SMQs:, Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), 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), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Sepsis (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2012-09-02
   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: No
Current Illness: No
Preexisting Conditions: Recent otitis media - TM''s normal 8/28/12
Allergies:
Diagnostic Lab Data: Extensive evaluation at hospital
CDC Split Type:

Write-up: Vaccines given 8/28/12, 850am. Catastrophic event about 6pm 8/30/12. Found by family to be apneic, blue, unresponsive. To ER then to Hosp PICU. Hypoxic ischemic encephalopathy & multisystem organ failure. Brain dead & expired 09/02/12. Law enforcement & DSS notified - autopsy pending. No indication that death related to immunizations.


VAERS ID: 465916 (history)  
Form: Version 1.0  
Age: 81.0  
Sex: Male  
Location: Texas  
Vaccinated:2012-09-20
Onset:2012-09-21
   Days after vaccination:1
Submitted: 2012-09-21
   Days after onset:0
Entered: 2012-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE) / SANOFI PASTEUR U4494AA / UNK UN / IM

Administered by: Other       Purchased by: Public
Symptoms: Activities of daily living impaired, Death, Faecal incontinence, Musculoskeletal stiffness, Pain
SMQs:, Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Arthritis (broad), Noninfectious diarrhoea (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2012-09-21
   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: Losartan 50mg daily
Current Illness: No chronic disease noted
Preexisting Conditions: Diabetes; Hypertension
Allergies:
Diagnostic Lab Data: Since flu vaccine was adminstered within such a close timeframe, medical examiner thought that we should be aware and report to VAERS, the possible link of the vaccine to the patient''s death.
CDC Split Type:

Write-up: Patient complained of "achiness" around 2:30 to 3:00 pm. His symptoms progressed to stiffness and soreness by bedtime and needed help with his clothing before bed. Around Midnight, there was a loss of bowel control and he passed away.


VAERS ID: 465936 (history)  
Form: Version 1.0  
Age: 0.21  
Sex: Female  
Location: Florida  
Vaccinated:2011-12-14
Onset:2011-12-17
   Days after vaccination:3
Submitted: 2012-09-22
   Days after onset:279
Entered: 2012-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3840AA / 1 LL / IM
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVC022DA / UNK RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 916918 / 1 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0543AA / 1 MO / PO

Administered by: Unknown       Purchased by: Other
Symptoms: Autopsy, Death, Musculoskeletal stiffness, Respiratory arrest, Resuscitation, Sudden infant death syndrome
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), Neonatal disorders (narrow), Hypersensitivity (broad), Arthritis (broad), Respiratory failure (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2011-12-17
   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: Amoxicillin for upper respiratory infection; Nystatin oral for thrush; Desitin for diaper rash.
Current Illness: Upper respiratory infection; Rectal prolapse; Premature
Preexisting Conditions: Premature; Rectal prolapse; Lactose
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Woke up to baby face up, she looked fine, when I went to pick her up she was stiff still warm, but stiff, and not breathing, called 911 paramedics arrived and tried to resuscitate, she had been dead approx 12 mins. Med ex. said it was SIDS. Autopsy report cause of death "undetermined" manner of death: "undetermined, prematurity by history"


VAERS ID: 466002 (history)  
Form: Version 1.0  
Age: 0.17  
Sex: Male  
Location: Utah  
Vaccinated:2012-06-25
Onset:2012-06-26
   Days after vaccination:1
Submitted: 2012-07-19
   Days after onset:23
Entered: 2012-09-24
   Days after submission:67
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B305 / 1 LL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0254AA / 1 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH F89912 / 1 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0677AA / 1 MO / PO

Administered by: Private       Purchased by: Private
Symptoms: Autopsy, Death, Toxicologic test
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2012-06-26
   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: Dexamethasone 2mg
Current Illness: Viral Croup
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Toxicology pending / autopsy results pending
CDC Split Type:

Write-up: Patient seen in office for well child check, normal healthy child with viral symptoms. Immunizations performed, child tolerated well. Following morning found deceased.


VAERS ID: 466029 (history)  
Form: Version 1.0  
Age: 24.0  
Sex: Female  
Location: Florida  
Vaccinated:2012-09-11
Onset:0000-00-00
Submitted: 2012-09-20
Entered: 2012-09-24
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RAB: RABIES (IMOVAX) / SANOFI PASTEUR H1091 / 1 UN / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
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: Past medical history and illness at time of vaccination was reported as unknown.
Allergies:
Diagnostic Lab Data: Not reported.
CDC Split Type: 201208467

Write-up: Initial report was received from a health care professional on 12 September 2012. A 24-year-old female patient received dose one of an intramuscular injection of ("the rabies series") IMOVAX Rabies, sanofi pasteur SA, H1091-1 (indication and site and side of administration were not reported) on 11 September 2012. According to reporter, the patient did not have any reactions when she went home. The next day, it was reported that the client died during the night. Exact date of death was reported as unknown, either 11 September 2012 or 12 September 2012, as reported "during the night". The medical examiner was called to verify the death, and details were not available at the time of the report. No information was reported at this time on if an autopsy was performed. The patient''s outcome was fatal. Documents held by sender: None.


VAERS ID: 466326 (history)  
Form: Version 1.0  
Age: 3.0  
Sex: Male  
Location: West Virginia  
Vaccinated:2012-09-10
Onset:2012-09-14
   Days after vaccination:4
Submitted: 2012-09-25
   Days after onset:11
Entered: 2012-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUN3: INFLUENZA (SEASONAL) (FLUMIST) / MEDIMMUNE VACCINES, INC. AH2140 / 1 NS / IN

Administered by: Unknown       Purchased by: Public
Symptoms: Influenza virus test negative, Intensive care, Nasopharyngitis, Respiratory arrest
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Respiratory failure (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2012-09-20
   Days after onset: 6
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Miralax; Dulcolax; Erythromycin (EES); Iron; Poly-Vi-Sol; Lactulose
Current Illness: Mild URI for 1 day with no fever and no respiratory distress
Preexisting Conditions: Prematurity (31-32 weeks); G-tube dependent; Developmental delay; Atrial Septal Defect; Undiagnosed cause for muscle weakness; Constipation
Allergies:
Diagnostic Lab Data: Negative Influenza test result.
CDC Split Type:

Write-up: Respiratory arrest at home after 4 days of worsening cold symptoms. Driven by family auto to Medical Center and then transfered to PICU at another hospital.


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