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From the 11/12/2021 release of VAERS data:

This is VAERS ID 312251

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Case Details

VAERS ID: 312251 (history)  
Form: Version 1.0  
Age: 78.0  
Sex: Unknown  
Location: Pennsylvania  
Vaccinated:2008-01-07
Onset:2008-02-05
   Days after vaccination:29
Submitted: 2008-05-13
   Days after onset:97
Entered: 2008-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. - / UNK - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Chronic obstructive pulmonary disease, Condition aggravated
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2008-02-10
   Days after onset: 5
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: COPD
Preexisting Conditions: PMH: Emphysema/COPD, HTN, hypercholesterolemia, basal cell carcinoma. NKDA. Past hx of smoking-quit 2001.
Allergies:
Diagnostic Lab Data: Labs and Diagnostics: Troponin 0.25, 1.14. Creatinine 1.9. BUN 39 up to 52. EKG sinus tach with PVCs. CBC with WBCs 5.9. Hgb initially 13.1 down to 11.1 CXR with no acute infiltrates (+) emphysematous changes. Stool hemoccult (+).
CDC Split Type:

Write-up: Subject in pneumococcal vaccine trial, with severe COPD, was hospitalized for COPD exacerbation. Vaccination took place on 1/7/2008 and hospital admission was on 2/5/2008. According to the physician, relationship to treatment is ''None''. We would be happy to forward the Study''s SAE Report Form upon request. 5/19/2008 MR received for DOS 2/5-10/2008 with D/C DX: Non-ST segment elevation Myocardial Infarction. Acute on chronic respiratory failure. Acute on chronic renal failure. Atrial Fibrillation with rapid ventricular response. Acute Bronchitis. COPD. Gastrointestinal bleeding. Anemia. Hyperlipidemia. Pt presented to ER with 2 day hx of cough and fever with worsening shortness of breath with diaphoresis. Pt also had diarrhea 1 day prior to ER visit. On admission, troponin was (+). PE (+) for I&E wheezing and decreased breath sounds. Pt developed atrial fib, GI bleeding, and acute on chronic renal failure during hospitalization: multi-system organ failure. Transferred to hospice on 2/10/08 per pt request. Pt expired on 2/11/08.


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