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

This is VAERS ID 417551

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Case Details

VAERS ID: 417551 (history)  
Form: Version 1.0  
Age: 89.0  
Sex: Female  
Location: California  
Vaccinated:2011-02-17
Onset:2011-02-19
   Days after vaccination:2
Submitted: 2011-02-24
   Days after onset:5
Entered: 2011-02-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
TD: TD ADSORBED (NO BRAND NAME) / SANOFI PASTEUR U2591AA / UNK LA / IM

Administered by: Private       Purchased by: Unknown
Symptoms: Asthenia, Dysphagia, Muscle spasms
SMQs:, Anticholinergic syndrome (broad), Dystonia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2011-02-26
   Days after onset: 7
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt. suffered a fall about 2 weeks ago and had abrasion and received tetanus vaccine and about 48 hours post vaccination she became extremely weak with dysphagia and increased muscle spasm.


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