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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 31 out of 297

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VAERS ID: 472279 (history)  
Form: Version 1.0  
Age: 62.0  
Sex: Male  
Location: New Hampshire  
Vaccinated:2012-10-11
Onset:2012-10-13
   Days after vaccination:2
Submitted: 2012-10-26
   Days after onset:13
Entered: 2012-10-31
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (AFLURIA) / CSL LIMITED P58306 / UNK UN / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2012-10-13
   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: Recent massive heart attack; Narcolepsy
Allergies:
Diagnostic Lab Data:
CDC Split Type: 2012033702

Write-up: This medically confirmed spontaneous report (initial receipt: 18-Oct-2012) concerns a 62-year-old male patient, who had a medical history of recent massive heart attack and narcolepsy. He had no known drug allergy. He was taking ''a lot of medications'' (type unspecified). On 11-Oct-2012 the patient received AFLURIA (batch number: P58306) injection at a dose of 0.5 mL intramuscularly. On the day of vaccination, the patient did not complain of any symptoms and went home without any adverse events. On 13-Oct-2012 the patient was found dead. The cause of death was still being investigated. According to the pharmacist (reporter), the patient had many health problems including a recent massive heart attack (date unspecified).


VAERS ID: 472319 (history)  
Form: Version 1.0  
Age: 0.34  
Sex: Female  
Location: Washington  
Vaccinated:2012-10-25
Onset:2012-10-27
   Days after vaccination:2
Submitted: 2012-10-31
   Days after onset:4
Entered: 2012-10-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C4204AA / 2 LL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F70997 / 2 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0058AE / 2 MO / PO

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2012-10-27
   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: No
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: SIDS.


VAERS ID: 473170 (history)  
Form: Version 1.0  
Age: 74.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2012-08-01
Onset:2012-08-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2012-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / UN

Administered by: Unknown       Purchased by: Unknown
Symptoms: Acute disseminated encephalomyelitis, Demyelination, Myelitis transverse, Nuclear magnetic resonance imaging brain abnormal
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (narrow), Optic nerve disorders (broad), Demyelination (narrow), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2012-10-10
   Days after onset: 70
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: MRI consistent of ADEM.
CDC Split Type: HI1205

Write-up: Transverse myelitis. Region of demyelination in right frontal lobe.


VAERS ID: 473483 (history)  
Form: Version 1.0  
Age: 31.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2012-10-30
Onset:2012-10-31
   Days after vaccination:1
Submitted: 2012-11-07
   Days after onset:7
Entered: 2012-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB566AN / UNK LA / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR H1354 / UNK LA / IM
TYP: TYPHOID LIVE ORAL TY21A (VIVOTIF) / BERNA BIOTECH, LTD. 3000128 / UNK MO / PO
YF: YELLOW FEVER (YF-VAX) / SANOFI PASTEUR UH296AB / UNK LA / SC

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2012-10-31
   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: Soma
Current Illness: No
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pronounced dead at home in bed.


VAERS ID: 473692 (history)  
Form: Version 1.0  
Age: 0.15  
Sex: Female  
Location: Arkansas  
Vaccinated:2012-10-30
Onset:2012-11-04
   Days after vaccination:5
Submitted: 2012-11-08
   Days after onset:4
Entered: 2012-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B351AB / 1 LL / UN
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 1070AA / 1 RL / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH 918131 / 1 RL / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB27BA / 1 MO / PO

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2012-11-04
   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: Fever
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Child passed away 11/4/12. Autopsy pending - cause of death unknown.


VAERS ID: 473737 (history)  
Form: Version 1.0  
Age: 0.35  
Sex: Male  
Location: Missouri  
Vaccinated:2012-05-18
Onset:2012-05-21
   Days after vaccination:3
Submitted: 2012-10-23
   Days after onset:155
Entered: 2012-11-09
   Days after submission:17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C4221AA / 2 RL / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F89912 / 2 RL / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1847AA / 2 MO / PO

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2012-05-21
   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:
Current Illness: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient died from unknown cause within 3 days of vaccine series. Death deemed SIDS.


VAERS ID: 475000 (history)  
Form: Version 1.0  
Age: 0.35  
Sex: Male  
Location: Virginia  
Vaccinated:2012-11-16
Onset:2012-11-16
   Days after vaccination:0
Submitted: 2012-11-19
   Days after onset:3
Entered: 2012-11-21
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C4259AA / 2 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 918131 / 2 RL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41CB291A / 2 MO / PO

Administered by: Public       Purchased by: Public
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2012-11-19
   Days after onset: 3
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:
Current Illness: None
Preexisting Conditions: Hydronephrosis; Fussy infant/baby
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt. was taken to the hospital for sx''s of high fever. Seen by resident.


VAERS ID: 475174 (history)  
Form: Version 1.0  
Age: 88.0  
Sex: Female  
Location: Unknown  
Vaccinated:2012-09-22
Onset:2012-10-08
   Days after vaccination:16
Submitted: 2012-11-21
   Days after onset:44
Entered: 2012-11-26
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE INTRADERMAL) / SANOFI PASTEUR UT4466BA / UNK UN / ID

Administered by: Unknown       Purchased by: Unknown
Symptoms: Death, Drug administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2012-10-08
   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:
Current Illness:
Preexisting Conditions: The patient''s past medical history was reported as not applicable (n/a) and illness at time of vaccination was reported as none. The patient used home oxygen.
Allergies:
Diagnostic Lab Data: Not reported.
CDC Split Type: 201210777

Write-up: Initial report was received from a consumer on 14 November 2012, and involves a case of misuse, inappropriate age at vaccine administration. An 88-year-old female patient received an injection of FLUZONE Intradermal, sanofi pasteur Inc., (lot number, route, site, side and dose in series not reported) on 22 September 2012, which is indicated for patients 18 to 64 years of age. On 08 October 2012, 16 days post vaccination, the patient was found dead. The patient''s past medical history was reported as not applicable (n/a) and illness at time of vaccination was reported as none. The patient used home oxygen. It was not reported if an autopsy was done. No other details were provided. The patient''s outcome was reported as fatal on 08 October 2012. Documents held by sender: None.


VAERS ID: 475176 (history)  
Form: Version 1.0  
Age: 0.33  
Sex: Male  
Location: Washington  
Vaccinated:2012-10-29
Onset:2012-11-01
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2012-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B351BA / 1 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UH624AA / 2 LL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F70997 / 2 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0059AE / 2 MO / PO

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2012-11-01
   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: None
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Died of SIDS 2 days after receiving vaccines.


VAERS ID: 441125 (history)  
Form: Version 1.0  
Age: 1.28  
Sex: Male  
Location: New Hampshire  
Vaccinated:2011-10-28
Onset:2011-10-31
   Days after vaccination:3
Submitted: 2012-11-25
   Days after onset:391
Entered: 2012-12-03
   Days after submission:8
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS AC14B136BB / 1 RL / IM
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR UT4118CA / 1 RL / IM
HIBV: HIB (HIBERIX) / GLAXOSMITHKLINE BIOLOGICALS AHIBC263BA / 1 LL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 916617 / 4 LL / IM

Administered by: Private       Purchased by: Public
Symptoms: Death, Resuscitation, 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: 2011-10-31
   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: Sodium fluoride
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: See medical examiner''s report
CDC Split Type:

Write-up: Was seen for 15 mo well child visit 10/28/2011 received DTaP, HIB, PCV 13 and influenza vaccines approximately 5pm exam was normal. Patient was at daycare 10/31/11 and found to be unresponsive after being put down for a nap. Brought to ER, pronounced dead after unsuccessful resuscitation attempt.


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