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This is VAERS ID 485762

History of Changes from the VAERS Wayback Machine

First Appeared on 3/12/2013

VAERS ID: 485762
VAERS Form:
Age:
Sex:Unknown
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2013-02-26
Entered:2013-02-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH - / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Death, Meningitis, Pneumonia streptococcal

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2013-02-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 2013066299

Write-up: This is a spontaneous report from a contactable physician through Pfizer Vaccine Representative. This physician reported for a 8 year old (unknown gender) patient who received a dose of PREVNAR 13 on unknown date. Relevant medical history and concomitant medication were unknown. It was reported that on an unknown date the patient had streptococcus pneumonia and meningitis. Therapeutic measures taken, if any, were unknown. The patient had not recovered from the reported events and passed away on an unknown date in Feb2013 due to streptococcus pneumonia and meningitis. At the time of reporting, it was unknown if autopsy was performed.


Changed on 9/14/2017

VAERS ID: 485762 Before After
VAERS Form:(blank) 1
Age:
Sex:Unknown
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2013-02-26
Entered:2013-02-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH - / - UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Death, Meningitis, Pneumonia streptococcal

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2013-02-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 2013066299

Write-up: This is a spontaneous report from a contactable physician through Pfizer Vaccine Representative. This physician reported for a 8 year old (unknown gender) patient who received a dose of PREVNAR 13 on unknown date. Relevant medical history and concomitant medication were unknown. It was reported that on an unknown date the patient had streptococcus pneumonia and meningitis. Therapeutic measures taken, if any, were unknown. The patient had not recovered from the reported events and passed away on an unknown date in Feb2013 due to streptococcus pneumonia and meningitis. At the time of reporting, it was unknown if autopsy was performed.


Changed on 2/14/2018

VAERS ID: 485762 Before After
VAERS Form:1
Age:
Sex:Unknown
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2013-02-26
Entered:2013-02-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Death, Meningitis, Pneumonia streptococcal

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2013-02-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 2013066299

Write-up: This is a spontaneous report from a contactable physician through Pfizer Vaccine Representative. This physician reported for a 8 year old (unknown gender) patient who received a dose of PREVNAR 13 on unknown date. Relevant medical history and concomitant medication were unknown. It was reported that on an unknown date the patient had streptococcus pneumonia and meningitis. Therapeutic measures taken, if any, were unknown. The patient had not recovered from the reported events and passed away on an unknown date in Feb2013 due to streptococcus pneumonia and meningitis. At the time of reporting, it was unknown if autopsy was performed.


Changed on 6/14/2018

VAERS ID: 485762 Before After
VAERS Form:1
Age:
Sex:Unknown
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2013-02-26
Entered:2013-02-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Death, Meningitis, Pneumonia streptococcal

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2013-02-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 2013066299

Write-up: This is a spontaneous report from a contactable physician through Pfizer Vaccine Representative. This physician reported for a 8 year old (unknown gender) patient who received a dose of PREVNAR 13 on unknown date. Relevant medical history and concomitant medication were unknown. It was reported that on an unknown date the patient had streptococcus pneumonia and meningitis. Therapeutic measures taken, if any, were unknown. The patient had not recovered from the reported events and passed away on an unknown date in Feb2013 due to streptococcus pneumonia and meningitis. At the time of reporting, it was unknown if autopsy was performed.


Changed on 8/14/2018

VAERS ID: 485762 Before After
VAERS Form:1
Age:
Sex:Unknown
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2013-02-26
Entered:2013-02-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Death, Meningitis, Pneumonia streptococcal

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2013-02-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 2013066299

Write-up: This is a spontaneous report from a contactable physician through Pfizer Vaccine Representative. This physician reported for a 8 year old (unknown gender) patient who received a dose of PREVNAR 13 on unknown date. Relevant medical history and concomitant medication were unknown. It was reported that on an unknown date the patient had streptococcus pneumonia and meningitis. Therapeutic measures taken, if any, were unknown. The patient had not recovered from the reported events and passed away on an unknown date in Feb2013 due to streptococcus pneumonia and meningitis. At the time of reporting, it was unknown if autopsy was performed.


Changed on 9/14/2018

VAERS ID: 485762 Before After
VAERS Form:1
Age:
Sex:Unknown
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2013-02-26
Entered:2013-02-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Death, Meningitis, Pneumonia streptococcal

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2013-02-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 2013066299

Write-up: This is a spontaneous report from a contactable physician through Pfizer Vaccine Representative. This physician reported for a 8 year old (unknown gender) patient who received a dose of PREVNAR 13 on unknown date. Relevant medical history and concomitant medication were unknown. It was reported that on an unknown date the patient had streptococcus pneumonia and meningitis. Therapeutic measures taken, if any, were unknown. The patient had not recovered from the reported events and passed away on an unknown date in Feb2013 due to streptococcus pneumonia and meningitis. At the time of reporting, it was unknown if autopsy was performed.


Changed on 10/14/2018

VAERS ID: 485762 Before After
VAERS Form:1
Age:
Sex:Unknown
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2013-02-26
Entered:2013-02-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Death, Meningitis, Pneumonia streptococcal

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2013-02-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 2013066299

Write-up: This is a spontaneous report from a contactable physician through Pfizer Vaccine Representative. This physician reported for a 8 year old (unknown gender) patient who received a dose of PREVNAR 13 on unknown date. Relevant medical history and concomitant medication were unknown. It was reported that on an unknown date the patient had streptococcus pneumonia and meningitis. Therapeutic measures taken, if any, were unknown. The patient had not recovered from the reported events and passed away on an unknown date in Feb2013 due to streptococcus pneumonia and meningitis. At the time of reporting, it was unknown if autopsy was performed.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=485762&WAYBACKHISTORY=ON


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