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From the 9/17/2021 release of VAERS data:

Found 3,093 cases where Patient Died and Vaccination Date from '2007-08-01' to '2020-11-30'



Case Details

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VAERS ID: 297178 (history)  
Form: Version 1.0  
Age: 2.0  
Sex: Female  
Location: Texas  
Vaccinated:2007-11-07
Onset:2007-11-10
   Days after vaccination:3
Submitted: 2007-11-16
   Days after onset:6
Entered: 2007-11-19
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR U2156AA / 4 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF205AA / 4 LL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR Z0873 / 4 RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0706F / 1 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08702H / 4 RL / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 06084 / 1 RL / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Bronchopneumonia, Death, Electrolyte imbalance, Gastroenteritis, Histology, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2007-11-12
   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: NONE
Current Illness: NONE
Preexisting Conditions: PRE-MATURE BIRTH....NO COMPLICATIONS
Allergies:
Diagnostic Lab Data: Electrolytes with mild dehydrate. Histology shows acute gastroenteritis and broncho-pneumonia
CDC Split Type:

Write-up: Child started with high fever, 48 C, post vaccination and died on 11/12/2007. 12/11/2007 Reviewed autopsy report which states COD as acute bronchopneumonia complicated by acute gastroenteritis. Blood c/s neg.


VAERS ID: 297526 (history)  
Form: Version 1.0  
Age: 0.4  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2007-10-17
Onset:0000-00-00
Submitted: 2007-11-21
Entered: 2007-11-23
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B124DB / 2 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF220AA / 2 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B54007D / 2 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0239U / 2 MO / PO

Administered by: Private       Purchased by: Private
Symptoms: Cyanosis, Fatigue, Unresponsive to stimuli
SMQs:, Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (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: 2007-10-19
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/Small macular VSD
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: 2day hx of extra tired after shots. No other symptoms (D) 2 after shots/found non responsive/cyanotic/face down. 11/30/07 Reviewed vax record from pcp which confirms dose/lot as reported & provided vax date of 10/17/2007. 1/8/07 Reviewed autopsy report which states COD as SIDS. Other finding at autopsy was probe patent foramen ovale.


VAERS ID: 297528 (history)  
Form: Version 1.0  
Age: 12.0  
Sex: Female  
Location: Unknown  
Vaccinated:2007-09-15
Onset:2007-10-06
   Days after vaccination:21
Submitted: 2007-11-20
   Days after onset:45
Entered: 2007-11-23
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / UN

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

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2007-10-06
   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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0711USA02619

Write-up: Information has been received from a physician''s assistant concerning a 12 year old female with no reported medical history who on approximately 15-SEP-2007 was vaccinated with Gardasil. It was noted that this was not where the vaccine was administered, rather they were the patient''s family physician. On 06-OCT-2007 the patient died in her sleep. No further information was provided. No lot number was given. Additional information has been requested.


VAERS ID: 297565 (history)  
Form: Version 1.0  
Age: 55.0  
Sex: Male  
Location: Texas  
Vaccinated:2007-10-31
Onset:2007-11-13
   Days after vaccination:13
Submitted: 2007-11-22
   Days after onset:9
Entered: 2007-11-23
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUARIX) / GLAXOSMITHKLINE BIOLOGICALS AFLLA043AA / UNK UN / SC
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 0964U / UNK UN / SC

Administered by: Private       Purchased by: Private
Symptoms: CSF culture negative, CSF protein increased, Miller Fisher syndrome, Respiratory failure
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (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 (narrow), Ocular motility disorders (narrow), Hypersensitivity (broad), Respiratory failure (narrow), Hypokalaemia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2007-11-29
   Days after onset: 16
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 11 days
   Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness: Pemphigus Vulgaris. PE (+) for Pemphigus lesions, and thrush. Of note, CBC on date of vax with WBCs of 16.4 (low Eos 0.10%, lymph 4.0%, monos 4.40% and high neu 90.9%).
Preexisting Conditions: PMH: Pemphigus vulgaris on long-term steroids.
Allergies:
Diagnostic Lab Data: CSF; Protein/negative cxs. Labs and Diagnostics: CBC with WBCs of 16.1. PT/INR WNL. Head CT with no acute pathology on 11/18/07. MRI brain 11/19/07 with no evidence of acute pathology. CT brain scan 11/26/07 shows subarachnoid hemorrhage with diffuse cerebral edema, possible cerebellar tonsil herniation. Dopplar studies of the lower extremities WNL. Initial Chemistry with low Na+, Cl-, and Albumin 3.1 and glucose of 183. LFTs WNL on admission elevated by 11/25/07 (AST 67, ALT 120, Alk Phos 137, Total Protein 9.0 and Albumin 2.2). Sed rate 38. CSF protein 75.4. CSF Bacterial antigens (-). Initial Blood cultures (-). Later blood cultures (+) for Enterococcus fecalis.CSF cultures (-). UC (-). Cardiac enzymes unremarkable. ANA (-). Lyme and VDRL (-). CXR initially WNL later showed a L pleural reaction. EEG showed no cerebral activity.
CDC Split Type:

Write-up: Miller - Fisher Syndrome. Respiratory failure. 12/07/2007 MR received for DOS 11/18-29/2007 with DX: Miller-Fisher Syndrome. Pt expired on 11/29/2007. Progress note 11/28/07 states " diagnosis of brain death due to massive intracranial hemorrhage". Pt presented to ER on 11/18/07 with fever and progressive lower extremity weakness and swelling of the R side of face associated with weakness and numbness. Admission PE (+) for multiple superficial skin ulcers, bilateral conjunctival hemorrhage R$gL, L eyelid ptosis, R-sided facial weakness motor function 2/5 in lower extremities and nystagmus. Neuro consult 11/19/07 reports that pt developed double vision, trouble walking, and weakness 2 weeks s/p vaccination. PE (+) for 3rd and 6th cranial nerve palsy, ataxic gait, and absent DTRs. No respiratory problems at that time. Later that day pt developed agonal respirations and respiratory distress and mental status changes. Dx: Acute Respiratory Failure. Intubation was attempted and pt placed on ventilator. On 11/22/07 pt developed fever and started on abx. By 11/23/07 pt was unresponsive and developed myoclonic activity. On 11/29/07 pt was removed from life-support with dx of brain death due to massive intracranial hemorrhage. 12/07/2007 Death summary received as above. Final DX: Massive cerebrovascular accident with subarachnoid hemorrhage. Brain dead with flat EEG and (+) apnea test. Bactermia with enterococcus faecalis and coagulase-negative staphylococcus. S/P comatose state. Miller Fisher Syndrome on admission. pemphigus vulgaris. S/P respiratory failure. 01/11/2008 Death Cert received. Immediate COD: Cerebrovascular Accident-Approximate interval:onset to death-hours. Ascending Polyneuropathy-onset to death: days. Pemphigus-onset to death: years.


VAERS ID: 298067 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Female  
Location: California  
Vaccinated:2007-11-20
Onset:2007-11-25
   Days after vaccination:5
Submitted: 2007-11-26
   Days after onset:1
Entered: 2007-11-27
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B125BB / 1 RL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0260U / 1 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B972838 / 1 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1461U / 1 MO / PO

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2007-11-25
   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: None
Current Illness: Unable to breathe through nose
Preexisting Conditions: Cerebropalsy (L) arm; (L) cephalhematoma PMH: jaundice & left brachial plexus birth trauma both of which had resolved by 10/8. SVD w/vacuum assist at 35wks. Perinatal period complicated w/hypoglycemia which resolved before d/c to home.
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Death 10/21/08 Autopsy states COD as pneumonia, other undetermined factors, sudden unexpected infant death. Manner of death is undetermined. Autopsy report also states patient found unresponsive in crib in lateral position on a pillow. X-rays revealed healing rib & clavicular fractures. Micro revealed evidence of bronchopneumonia. Investigation revealed patient had cough & nasal congestion x approx 10 days prior to death & had been seen in ER & by PCP for same. Ears had been pierced day before death. 11/30/07 Reviewed pcp medical records which confirm dose & lot as reported. Office note of 11/20 reveals patient had nasal congestion x 1 week. Dx w/formula allergy & formula changed to soy. Had been seen in ER 11/17 for cough with chest/nasal congestion. Exam revealed a sore in left nostril.


VAERS ID: 298149 (history)  
Form: Version 1.0  
Age: 87.0  
Sex: Male  
Location: Indiana  
Vaccinated:2007-11-16
Onset:2007-11-23
   Days after vaccination:7
Submitted: 2007-11-29
   Days after onset:6
Entered: 2007-11-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER LIVE (ZOSTAVAX) / MERCK & CO. INC. 0880U / 1 LA / SC

Administered by: Unknown       Purchased by: Unknown
Symptoms: Ear pain, Herpes zoster, Oral disorder, Otorrhoea, Rash, Rash vesicular, Swelling face, Tympanic membrane perforation
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Accidents and injuries (broad), Hearing impairment (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2007-12-05
   Days after onset: 12
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: Correg, Prilosec, ASA, Synthroid, Lasix, Cordarone, Sennekot, Lortab, Aricept, Naprosyn, Citracal, had received steroid injection in spine for pain control
Current Illness: none
Preexisting Conditions: atrial fibrillation, congestive heart failure, arthritis, hyperlipidemia, back pain PMH: atrial flutter, DJD, GERD, colonic polyps, hyperlipidemia, allergic rhinitis
Allergies:
Diagnostic Lab Data: LABS: initial CT scan WNL. MRI revealed midbrain CVA in pons.
CDC Split Type:

Write-up: Patient received Zoster vaccination on 11/16/07. Onset of left ear pain on 11-23-07. Mild rash reported on left side of face and ear (vesicular). Left ear drainage. Pain and rash increased and was seen in Emergency Dept. on 11/25/07. Diagnosis of shingles secondary to vaccination was made. Follow up to personal physician on 11/26/07 reports leisons inside mouth, rash and pain on left side only and a ruptured ear drum. Mild facial swelling, on left noted. Was treated with Famvir 500 mg tid, Medrol dose pack and Zithromax 5 day course. Follow up on 11/28/07 reports improvement in symtoms. 12/21/07 Reviewed death certificate which reveals COD as respiratory failure, cardiac arrest & CVA. 1/4/08 Reviewed hospital medical records which reveal patient experienced blisters & cold sores on the left mouth & left ear pain on 11/17 & went to ER. Tx w/steroids, antivirals & antibiotics & d/c to home. Improved initially then patient began to experience balance difficulty & multiple falls. Returned to hospital & was admitted 11/30-12/5/2007. Patient developed respiratory distress which progressed to cardiopulmonary arrest. Resuscitated, intubated & transferred to ICU. Was able to be extubated but had trouble swallowing. Otherwise progressed well until 12/5 when developed sudden onset of bradycardia leading to asystole & expiration. FINAL DX: herpes zoster, CVA, respiratory failure, cardiopulmonary arrest.


VAERS ID: 298905 (history)  
Form: Version 1.0  
Age: 0.5  
Sex: Male  
Location: Virginia  
Vaccinated:2007-11-26
Onset:2007-11-27
   Days after vaccination:1
Submitted: 2007-11-30
   Days after onset:3
Entered: 2007-12-06
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR UT2474CA / 1 LL / IM

Administered by: Private       Purchased by: Public
Symptoms: Death, 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: 2007-11-27
   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: Also received Synagis at the same time
Current Illness: URI
Preexisting Conditions: Pulmonary atresia s/p VP shunt/HIV exposure PMH: chronic hypoxia. Had cardiac cath done 11/20/07.
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient collapsed while eating breakfast at home. He was taken to the ER and pronounced dead. 12/18/07 Reviewed hospital ER records which reveal patient in usual state of health on 11/27 when coughed & then collapsed at home. Was unresponsive in ER & resuscitation unsuccessful. ER COD stated as sudden cardiac death. 1/21/08 Reviewed autopsy report which states COD as complication from congenital cardiac disease (probable arrhythmia.


VAERS ID: 299062 (history)  
Form: Version 1.0  
Age: 67.0  
Sex: Male  
Location: Nebraska  
Vaccinated:2007-11-19
Onset:2007-11-21
   Days after vaccination:2
Submitted: 2007-12-07
   Days after onset:16
Entered: 2007-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER LIVE (ZOSTAVAX) / MERCK & CO. INC. 1085U / 1 LA / SC

Administered by: Military       Purchased by: Military
Symptoms: Arthralgia, Balance disorder, Blood sodium decreased, Chromaturia, Diet refusal, Differential white blood cell count, Ejection fraction decreased, Fall, Feeling abnormal, Insomnia, Musculoskeletal pain, Myalgia, Myoglobin blood increased, Nausea, Pharyngolaryngeal pain, Platelet count normal, Protein urine present, Red blood cells urine positive, Renal failure acute, Rhabdomyolysis, Urine analysis abnormal, Urine output decreased
SMQs:, Rhabdomyolysis/myopathy (narrow), Acute renal failure (narrow), Cardiac failure (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (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), Dementia (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hyponatraemia/SIADH (narrow), Cardiomyopathy (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Chronic kidney disease (broad), Arthritis (broad), Tumour lysis syndrome (broad), Proteinuria (narrow), Tubulointerstitial diseases (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2007-11-25
   Days after onset: 4
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: 1) Albuterol 90/Ipratrop 18mcg 200d Po Inhl Inhale 2 Puffs By Mouth Four Times A Day 2) Aloh/Mgoh/Simeth/Diphen/Lidocaine Visc Rinse 2 Teaspoonfuls By Mouth Every 4 Hours (2x16oz Bottles (Equal Parts Of Each Ingredient) 3) As
Current Illness: 1. COPD, not on oxygen, never had PFTs acc to patient 2. HyperLipidemia 3. HTN 4. osteoarthritis of knees 5. Depression 6. Carcinoma of tonsil - completed treatment 1 year ago
Preexisting Conditions: NKDA PMH: throat cancer w/radiation treatment 1 year ago. HTN, hyperlipidemia, COPD, OA, depression, tonsillar carcinoma. Obese. Ex-smoker, (+) ETOH use. Ex-drug user.
Allergies:
Diagnostic Lab Data: Labs include: WBC 6.29 Hgb14.9 Platelets 156 band neut 77% segs 17% lymph 2%. Na 125 K 4.1 Cl 89 Co2 19 BUN 51 Creat 3.8 Glu 103 Ca 8.9. May 2.3 ESR 17. CK 5225, CKMB 109.4, RI 2.1. Myoglobin $g4000 Trop .67. ---- ABG ---- ARTERIA 11/25 11/25 Reference 2007 2007 19:06 18:00 Units Ranges ------------------------------------------------------------------------------- pH 7.22 L* 7.05 L* 7.35 to 7.45 PCO2 34 L 38 mmHg 35 to 45 pO2 194 H 253 H mmHg 80 to 95 BASE EX -13 L -21 L mmol/L -2 to 2 HCO3 13 L 10 L mmol/L 22 to 26 TCO2CAL 23 to 27 O2SAT-C 99 100 % 95 to 100 ER LABS: CT of head WNL. CXR WNL. WBC 6000, bands 77% (H), segs 12% (L), lymphs 2% (L). Electrolytes multiple abnormalities: Na 125 (L), Cl 89 (L), Bicarb 19 (L), BUN 51 (H), creat 3.8 (H). Rapid flu test neg. UA showed trace blood & protein 30 (H). CK enzymes 5,200 (H), CK-MB 109.4 (H), troponin I 0.67 (H). Myoglobin 4,000 (H). EKG showed sinus rhythm. Blood c/s (+) group G beta streptococcus. Hospital LABS: WBC 2.8 (L), Na 122 (L), BUN/creat 54/3.7 (H), AST 408 (H), ALT 73 (H)CK 15,404 (H), Troponin I 1.36 (H). Blood c/s neg. Adenosine cardiolite in 2/06 revealed EF 58% & small fixed perfusion w/no reversible defect.
CDC Split Type:

Write-up: Copied from Admission note: Patient is a 67 year old white gentleman with a past med hx sig for HL, HTN, COPD, OA, Dep, and carcinoma of tonsil who was trassferred to Hospital for ARF and rhabdomyolysis. Patient states that he received the Zostavax immunization on Monday 11-19-07. On Wednesday 11-21-07, he began to feel bad. He states that he lost his balance and fell. This went away. On Thursday 11-22-07 he developed a severe sore throat. He took some mouthwash that he had left over from when he was receiving treatment for tonsillar cancer and this helped. He also felt some nausea on Thursday. On Friday 11-23-07, he developed right knee pain and could not get up out of bed. He wanted to "wait it out over the weekend" but felt horrible this am. He developed joint and muscle aches in his forearms, shoulders, ankles, and right knee so he went to the hospital today Sunday, 11-25-0. He has not slept in 4 days. He has not eaten since Wednesday. He denies any visual changes or headches. He denies any vomiting or diarrhea/constipation. Denies fevers or chills. Denies abd or back pain, sob, change in cough. States that he went to the hospital and they gave his IVF. He did urinate 200cc of brown urine there. Before that, he had not urinated since Friday. Currently he c/o joint aches and pains. Says that he does not feel up to walking around because he does not trust himself. Labs that were done in Lincoln includ: WBC 6.29 Hgb14.9 Platelets 156 band neut 77% segs 17% lymph 2%. Na 125 K 4.1 Cl 89 Co2 19 BUN 51 Creat 3.8 Glu 103 Ca 8.9. May 2.3 ESR 17. CK 5225, CKMB 109.4, RI 2.1. Myoglobin $g4000 Trop .67. CT of head done which was neg for acute problem - did show mild atrophy. Blood cultures drawn. UA performed and was yellow, slightly cloudy, sp grav $g1.030, ph 5, prot 30, trace blood. Patient states that he does not use oxygen at home for COPD and occ uses inhalers. Has not had PFTs done. Did have an adenosine cardiolyte 2/06 which showed EF of 58% and small fixed perfusion defect and no reversible defect. 12/11/07 Reviewed ER medical records of 11/25/07 which reveal patient experienced weakness. States patient had received pneumonia, flu & shingles vaccinations on 11/20/07. Developed sore throat, decreased appetite, dry cough, nausea & loss of balance w/multiple falls starting 11/22/07. Developed generalized body aches, weakness & difficulty walking. Had to lift right leg w/hands due to weakness. Transferred to higher level of care. FINAL ER DX: rhabdomyolysis w/renal failure & weakness. 1/29/08 Reviewed hospital medical records of 11/25/07 which reveal patient transfered from outlying ER for acute renal failure & rhabdomyolyis. Records state zoster vax 7 days prior to admit & flu shot 2 weeks prior to admit. Pst developed balance difficulty, falls, sore throat, nausea, joint pains, muscle aches, sleep disturbance, decreased appetite. Admitted & shortly after admission found w/dusky face, stiff jaw, swollen neck, decreased air intake. Intubated & CPR started. Resuscitated & ABG revealed severe acidosis. Transferred to ICU. Developed v tach, resuscitated several times & eventually failed to respond. FINAL DX: Cardiopulmonary arrest; acute renal failure; rhabdomyolysis; HTN; hyperlipidemia; anxiety; COPD. 2/12/08 Reviewed autopsy report which states COD as septic shock w/acute rhabdomyolysis & renal failure.


VAERS ID: 299540 (history)  
Form: Version 1.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2007-11-30
Onset:0000-00-00
Submitted: 2007-12-12
Entered: 2007-12-13
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER LIVE (ZOSTAVAX) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Death, Myocardial infarction
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow)

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: Unknown
Current Illness: general symptom
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0712USA01742

Write-up: Information has been received from a physician concerning a female with "some health troubles" who on 30-NOV-2007 was vaccinated with Zostavax single dose of the series. The patient had a heart attack and died. The physician mention that she does not think it was due to Zostavax as the patient had "some health trouble before." Additional information is not expected.


VAERS ID: 299556 (history)  
Form: Version 1.0  
Age: 0.1  
Sex: Female  
Location: Illinois  
Vaccinated:2007-11-29
Onset:2007-11-30
   Days after vaccination:1
Submitted: 2007-12-13
   Days after onset:13
Entered: 2007-12-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B218AB / 1 RL / UN
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0819U / 1 LL / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B54015E / 1 LL / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1192U / 1 MO / PO

Administered by: Private       Purchased by: Public
Symptoms: 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: 2007-11-30
   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: born 36 wks gest., 5lb 6oz at birth PMH: 1st born. 36 wk preemie. NVD induced due to low amniotic fluid. Birth wt 5 lbs 6 oz. Home in 2 days. Grandmother had lost baby to SIDS in 1994.
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Pt found expired no breathing - non responsive next AM after getting shots. 12/18/07 Reviewed provider medical records including vax records which confirm vax dose & lot #s as reported. Family found patient not breathing in crib. 07/04/2008 Reviewed the pathology report received via fax from CDC: FINAL DX: mild focal tracheitis & vascular congestion of multiple organs. No immunohistochemical or PCR based evidence of influenza A or B, mycoplasma pneumoniae or bacillus cereus. No infectious etiology identified. 9/11/09 Autopsy report received. DOD 11/30/07 - Sudden Infant Death Syndrome.


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