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

This is VAERS ID 435682

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Case Details

VAERS ID: 435682 (history)  
Form: Version 1.0  
Age: 0.02  
Sex: Male  
Location: New Hampshire  
Vaccinated:2011-05-16
Onset:2011-05-28
   Days after vaccination:12
Submitted: 2011-09-12
   Days after onset:107
Entered: 2011-09-22
   Days after submission:10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 8482Z / 1 UN / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2011-05-28
   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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: 08121114

Write-up: Death.


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