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This is VAERS ID 150145

Case Details

VAERS ID: 150145 (history)  
Form: Version 1.0  
Age: 71.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:2000-01-19
Submitted: 2000-03-13
   Days after onset:54
Entered: 2000-03-16
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH - / UNK - / IM

Administered by: Other       Purchased by: Other
Symptoms: Bacterial infection, Pneumonia, Sepsis
SMQs:, Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Sepsis (narrow), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2000-01-19
   Days after onset: 0
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: UNK
Current Illness: UNK
Preexisting Conditions: Hodgkin''s disease (NOS), Vitamin B12 deficiency, Splenectomy
Allergies:
Diagnostic Lab Data: Blood culture (+) strep pneumonia-1/19/00
CDC Split Type: HQ1509410MAR2000

Write-up: A pt received an injection of pneumococcal vax and subsequently died. No further information was available at the date of this report. Follow-up reports a dx of pneumonia and sepsis. Cause of death was reported as "septic shock associated with pneumococcal bacteremia".


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