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From the 5/7/2021 release of VAERS data:

This is VAERS ID 827846



Case Details

VAERS ID: 827846 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2019-05-14
Onset:2019-06-01
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2019-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUA3: INFLUENZA (SEASONAL) (FLUAD) / NOVARTIS VACCINES AND DIAGNOSTICS NO BATCH NUMBER / UNK - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chest X-ray, Death, Depressed level of consciousness, Endotracheal intubation, Guillain-Barre syndrome, Intensive care, Lumbar puncture, Magnetic resonance imaging, Pneumonia, Respiratory failure
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Demyelination (narrow), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (narrow), Hypokalaemia (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2019-06-25
   Days after onset: 24
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Anaemia; Cholecystectomy; COPD; Dyslipidaemia; Gastroesophageal reflux disease
Allergies:
Diagnostic Lab Data:
CDC Split Type: AUSEQIRUS201904251

Write-up: Obtunded; Ventilator-aquired pneumonia; Respiratory failure; Guillain-Barre syndrome; This is a serious spontaneous case reported from other health care professional to TGA (reference number: AU-TGA-0000469653) and initially retrieved on 26-Jul-2019, concerning an 80-year-old female patient. The patient''s medical history included dyslipidaemia, gastroesophageal reflux disease (GORD), chronic obstructive pulmonary disease (COPD), cholecystectomy and anaemia. On 14-May-2019, the patient administered Fluad [influenza virus haemagglutinin, dose reported as: 1 dose unspecified, route of administration intramuscular, anatomical location, batch number, expiry date: not reported] for vaccination. On 09-Jun-2019, the patient developed Guillain-Barre syndrome. On 12-Jun-2019, the patient was admitted to intensive care unit (ICU) with respiratory failure and was obtunded. The patient was intubated on admission and underwent on following procedures: chest x-ray, magnetic resonance imaging (MRI) and lumbar puncture, however results were not provided. During ICU admission the patient developed ventilator-acquired pneumonia and escalation of antimicrobial therapy. The patient died on 25-Jun-2019. As reported, nerve conduction studies were ordered but patient died before it was performed. The outcome of the events of respiratory failure, obtundation and ventilator-acquired pneumonia was unknown. The reporter assessed the case as serious (death, hospitalization) and possibly related to Fluad.; Sender''s Comments: The patient developed Guillain-Barre syndrome, respiratory failure, depressed level of consciousness and pneumonia bacterial after vaccination with the suspect product Fluad (TIV). Chronology is plausible. Reportedly, the patient died due to Guillain-Barre syndrome. Medical history of chronic obstructive pulmonary disease and advanced age (80) may have contributed to development of the events. More information regarding autopsy and concomitant drugs is needed. Based on provided information, causality is assessed as related for all events except for pneumonia bacterial (reported as ventilator-acquired pneumonia).; Reported Cause(s) of Death: Guillain-Barre syndrome


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