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This is VAERS ID 835698

History of Changes from the VAERS Wayback Machine

First Appeared on 2/14/2020

VAERS ID: 835698
VAERS Form:2
Age:
Sex:Female
Location:Foreign
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:2019-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PPV: PNEUMO (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CO0095075131909COL010005

Write-up: DEATH; This spontaneous report was received from a regulatory authority refers to a 2-month-old female patient. There was no information about the patient''s concurrent conditions, concomitant therapies or medical history provided. On an unknown date, the patient was vaccinated with pneumococcal vaccine, polyvalent (23-valent) (manufacturer unknown) (lot #, expiry date, exact dose, anatomical location and route of administration were not reported) for prophylaxis. On an unknown date the, patient died. The cause of death was not reported. It was unknown whether autopsy was performed. The causality assessment was not reported. The agency considered this report to be serious.

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