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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

This is page 6 out of 310

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VAERS ID: 299871 (history)  
Form: Version 1.0  
Age: 77.0  
Sex: Male  
Location: New York  
Vaccinated:2007-11-30
Onset:2007-12-03
   Days after vaccination:3
Submitted: 2007-12-14
   Days after onset:11
Entered: 2007-12-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUARIX) / GLAXOSMITHKLINE BIOLOGICALS AFLUA282DA / 2 LA / IM

Administered by: Public       Purchased by: Public
Symptoms: Sudden death
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2007-12-03
   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: celiac disease
Preexisting Conditions: Aortic stenosis; Hyprtension
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient died suddenly while snowblowing. 12/18/07 Reporter states no autopsy done. Received vax record which confirms lot # as reported. 2/29/08 Received death certificate which states COD as cardiac arrest w/CAD as contributing factor.


VAERS ID: 299918 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Male  
Location: Oklahoma  
Vaccinated:2007-12-05
Onset:2007-12-08
   Days after vaccination:3
Submitted: 2007-12-14
   Days after onset:6
Entered: 2007-12-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B128AB / 1 RA / UN
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0995U / 1 LA / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B54013H / 1 LA / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1393U / 1 MO / PO

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2007-12-08
   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: Possible Reflux/Second Hand Smoke Exposure PMH: necrotizing enterocolitis at 1 wk of age. 2 1/2 wks premature. Birth HX: 6 lbs 12 oz, apgars 8/8 at 1/5 min. C-section due to fetal tachycardia & maternal temp of 100.6. Blood c/s neg.
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt. expired 3 days after ck-up. Parents reportedly found child dead in bed. 6/20/08 Autopsy states COD as SIDS. Report states pathological diagnosis as patent foramen ovale; lungs w/congestion & atelectasis; small bowel IS; GERD. Found unresponsive in bassinet after being placed prone approx 5 hrs earlier. CPR initiated 1/4/08 Reviewed pcp medical records & vax records which confirms vax as reported. Records indicate patient in good health on day of vax, only concern was constipation & formula changed.


VAERS ID: 300018 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Female  
Location: Unknown  
Vaccinated:2007-11-26
Onset:2007-11-28
   Days after vaccination:2
Submitted: 2007-12-14
   Days after onset:16
Entered: 2007-12-17
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B09AA / UNK LL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0498L / UNK RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B54013H / 1 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0902U / UNK MO / PO

Administered by: Other       Purchased by: Other
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2007-11-28
   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: Unknown
Preexisting Conditions: Relevant medical history was not provided. PMH: mother 16yo; 39 wk vaginal w/vacuum assist birth. Maternal temp & kept in hospital x 3 days w/mom.
Allergies:
Diagnostic Lab Data: death, unknown
CDC Split Type: USWYEH01681507

Write-up: Information regarding Prevnar was received from a healthcare professional regarding a female infant (between 0 and 6 months) who on 26-NOV-2007, received a first dose of Prevnar along with a dose of Haemophilus Influenzae B (manufacturer unknown), a dose of Pediarix and a dose of Rotarix. On 26-Nov-2007, the patient received a dose of Prevnar along with other childhood vaccines. On 28-Nov-2007, approximately 48 hours post-vaccination, the child died. The cause of death was unknown. An autopsy was performed, but results were not provided. No additional information was available at the time of this report. 1/22/08 Reviewed ER medical records of 11/28/07 which reveal patient found in crib by family. Transported to ER via EMS & pronounced DOA. 1/24/08 Reviewed pcp medical records which reveal patient in good health on 11/26/07 except for slight weakness of left arm & suspected brachial plexus birth injury. Note indicates patient received Pediarix, Prevnar, Hib & Rotavirus vaccines but no vax record included w/notes. 2/12/08 Received vax records. 5/6/08 Autopsy report states COD as SIDS. Manner of death: natural.


VAERS ID: 300036 (history)  
Form: Version 1.0  
Age: 0.3  
Sex: Female  
Location: South Carolina  
Vaccinated:2007-09-19
Onset:2007-09-20
   Days after vaccination:1
Submitted: 2007-12-17
   Days after onset:88
Entered: 2007-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B115CB / 2 LL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0256U / 2 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0553U / 2 MO / PO

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2007-09-20
   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: TYLENOL OTC
Current Illness: COLD LIKE SYMPTOMS
Preexisting Conditions: NONE. PMH: Former 34-36 week premie with IUGR. Birth weight 4-14. Developed respiratory distress syndrome requiring CPAP and O2. Resolved in 2-3 days. Infant on abx while r/o sepsis-sepsis screen (-). (+) neonatal jaundice. (+) diaper rash. Initial newborn thyroid screen-abnormal. F/U WNL (TSH 5.161, T4 1.43). URI 6/20/07. II/IV Systolic murmer noted 7/24/07 and 9/19/07. Otherwise normal exams.
Allergies:
Diagnostic Lab Data: INVESTIGATION, AUTOPSY AND TOXICOLOGY COMPLETED
CDC Split Type:

Write-up: INFANT DECEASED 16 HRS. POST IMMUNIZATION ADMINISTRATION. NO ADVERSE SIGNS OR SYMPTOMS DESCRIBED BY MOTHER. AUTOPSY DID NOT IDENTIFY ANY SIGNS OF ADVERSE REACTION. 12/26/2007 Vax record and MR received from PCP. Vax record as reported on VAERS report. 1/11/2008 Autopsy Report received with Child Fatality Investigation Report. COD: Sudden Unexpected Death in Infancy. Infant had been sleeping on sofa with mother. Mother felt child was warm and gave Tylenol. Respiratory Distress was noted by mom. EMS notified and CPR initiated however child was pronounced dead upon arrival at medical center. Unsafe sleeping conditions documented. Distinction between SIDS and subtle forms of asphyxia could not be made by autopsy alone.


VAERS ID: 300066 (history)  
Form: Version 1.0  
Age: 26.0  
Sex: Female  
Location: Texas  
Vaccinated:2007-11-12
Onset:0000-00-00
Submitted: 2007-12-14
Entered: 2007-12-17
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0106U / 2 UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2007-11-25
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: Obesity
Preexisting Conditions: Asthma, morbid obesity, smoker, occasional ETOH. OCP unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0712USA02658

Write-up: Information has been received from a physician concerning a large female who received one dose of Gardasil. Subsequently, the patient was found dead in her truck from a blood clot that traveled from her legs to her lungs. The cause of death was reported to be a blood clot. Additional information has been requested. 3/5/08 Autopsy states COD as pulmonary thromboembolus w/deep vein thrombosis of right leg & obesity as contributing factor.


VAERS ID: 300259 (history)  
Form: Version 1.0  
Age: 0.4  
Sex: Female  
Location: Virginia  
Vaccinated:2007-12-05
Onset:2007-12-07
   Days after vaccination:2
Submitted: 2007-12-10
   Days after onset:3
Entered: 2007-12-18
   Days after submission:8
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / SANOFI PASTEUR U2289CA / 2 LL / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08700B / 2 RL / UN

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2007-12-07
   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: Syragis manufactured by MedImmune, lot #055607 0.92ml R&L thigh, 1st dose; Immune-globin manufactured by Gamastan-Tafecris, lot #26N8782, IM L thigh, 1st dose
Current Illness: Hypoplastic (L) Heart Syndrome
Preexisting Conditions: Mitralatresia - Aortic Atresia; Supraventricular tachycardia; GER reflux; (L) Vocal cord paresis
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Complex congenital heart (hypoplastic (L)) repair with a modified normal/sano content. Vaccination 12/5 county on K/G expired en route to hospital 12/7. No post done at hospital. Vaccines were all #2 except Synagis #1.12/26/07-ER notes from facility for DOS 12/7/07-12/26/07-DX: cardiac arrest. Congenital heart anomaly. No autopsy performed. 12/27/07-COD hypoplastic left ventricle. CHF.


VAERS ID: 300400 (history)  
Form: Version 1.0  
Age: 0.33  
Sex: Male  
Location: Arizona  
Vaccinated:2007-12-11
Onset:2007-12-11
   Days after vaccination:0
Submitted: 2007-12-19
   Days after onset:8
Entered: 2007-12-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B133AA / 2 RL / IM
HBPV: HIB POLYSACCHARIDE (HIBIMUNE) / PFIZER/WYETH 0500U / 2 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B54015D / 2 LL / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Death, Nervous system disorder
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2007-12-12
   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: Received Synagis at same visit
Current Illness: None, did have chronic problems
Preexisting Conditions: Holoproencephaly, hydrocephalus, blindness, G-tube dependent
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient died the night he was given immunizations; he had a chronic neurological condition of unknown etiology. 5/2/08 Reviewed ER medical records which consisted of EKG strip showing asystole & a copy of death certificate which states DOD as 12/12/2007 & COD stated as cardiopulmonary arrest; aspiration; congenital brain malformation. No autopsy was done.


VAERS ID: 300760 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Male  
Location: New York  
Vaccinated:2007-12-06
Onset:2007-12-08
   Days after vaccination:2
Submitted: 2007-12-12
   Days after onset:4
Entered: 2007-12-21
   Days after submission:9
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B097AB / 1 LL / UN
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF201AB / 1 LL / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08690D / 1 LL / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1129U / 1 MO / PO

Administered by: Public       Purchased by: Public
Symptoms: Asphyxia, Death
SMQs:, Acute central respiratory depression (broad), Hostility/aggression (broad), Respiratory failure (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2007-12-08
   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: Thrush
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient expired on 12/8/07 after an accidental suffocation at home.


VAERS ID: 300774 (history)  
Form: Version 1.0  
Age: 0.28  
Sex: Male  
Location: California  
Vaccinated:2007-12-11
Onset:2007-12-13
   Days after vaccination:2
Submitted: 2007-12-21
   Days after onset:8
Entered: 2007-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B115AA / 1 RL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0436U / 1 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B97283B / 1 LL / IM

Administered by: Military       Purchased by: Military
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2007-12-13
   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: URI symptoms
Preexisting Conditions: 37 Week Twin
Allergies:
Diagnostic Lab Data: Autopsy
CDC Split Type:

Write-up: Found Dead in Crib 2/27/2008 Autopsy Summary received with COD: Sudden Infant Death Syndrome (SIDS). Contributing: Acute Bilateral Otitis Media.


VAERS ID: 300901 (history)  
Form: Version 1.0  
Age: 0.6  
Sex: Female  
Location: Unknown  
Vaccinated:2007-12-04
Onset:2007-12-07
   Days after vaccination:3
Submitted: 2007-12-21
   Days after onset:14
Entered: 2007-12-26
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS ACZ1B101AA / UNK RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF054AA / UNK RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B47300A / UNK LL / IM

Administered by: Other       Purchased by: Other
Symptoms: Death, Meningitis
SMQs:, Noninfectious meningitis (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2007-12-12
   Days after onset: 5
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown. PMH: none.
Allergies:
Diagnostic Lab Data: Unknown. Labs and Diagnostics: WBCs on 12/7 9.0 and UA (-). LP revealed purulent CSF with glucose 1, protein 232, WBCs 145,600 (82 polys) 149,000 RBCs with GPC (unidentified) and GNR (E.coli) on Gram stain. Many intra and extracellular bacteria. CBC showed WBCs 22, BMP and UA WNL. Blood cx (+) for E. coli. Head CT with mildly dilated ventricles and evidence of meningitis. F/U head CT showed large areas of infarction bilat with hydrocephalus.
CDC Split Type: WAES0712USA08252

Write-up: Information has been received from a nurse practitioner, concerning an infant (gender and specific age not reported) who on an unknown date was vaccinated with a dose of PedvaxHIB (lot # not reported) and the day after vaccination died in the hospital, from meningitis (no details available). The NP stated there were "rumors in the community" that the death was related to PedvaxHIB. She felt it was possibly related to the vaccine recall, and had received "no definitive information." No further details were provided. Additional information has been requested. 12/28/07 No autopsy done per Decedant Affairs rep at hospital./pc 12/31/2007 Vax record and WCC of 12/04/2007 received from CDC. No concerns at this time. Temp 99.1''F. PE WNL. 01/04/2008 Death Cert received. COD: meningitis. 01/22/2008 MR received from hospital for DOS 12/11-12/2008. Child presented to ER after transfer from local hospital with DX: Meningitis and altered mental status. Initially seen by PCP on 12/7/07 for fever/vomiting. Pt has several 2-3 min seizure-like episodes: eyes rolling back and spacing out x 1 minute. No T-C activity. (+) irritability. Presented again to local hospital 12/9/07 with increasing irritability, emesis with nuchal rigidity. Pt admitted to ICU with (+) eye rolling, responsive only to painful stimuli. Pt had further seizures. Transferred following head CT showing large bi-hemispheric strokes. Intubated and sedated. Externalized ventricular shunt placed for CSF drainage. Neuro condition deteriorated progressively (posturing, not responsive to any stimuli) to brain death. Pt was extubated and care withdrawn per parent request. Pt expired at 1712. Assessment: Polybacterial meningitis, Hydrocephalus. 01/29/2008 D/C summary received for above hospitalization. Principal Final DX: Escherichia coli meningitis. Additional DX: Bilateral cerbral infarcts and hydrocephalus with increased intracranial pressure and seizures.


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