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This is VAERS ID 835837

Case Details

VAERS ID: 835837 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2019-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / OT

Administered by: Other       Purchased by: ?
Symptoms: Death, Injection site hypersensitivity
SMQs:, Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
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: INSA2019SA263618

Write-up: patient had died; Allergic reaction around the spot of the injection; Initial information received on 20-Sep-2019 regarding an unsolicited valid serious social media case via Newspaper edition received from a consumer via (Patients Parent). This case involves a three months old male patient who experienced allergic reaction around the spot of the injection (injection site hypersensitivity) and died, while he received vaccine POLIOMYELITIS VACCINE (INACTIVATED). The patient''s past medical history, medical treatment(s), vaccination(s) and family history were not provided. On an unknown date, the patient received a dose of suspect POLIOMYELITIS VACCINE (INACTIVATED) in injection form produced by unknown manufacturer lot number not reported via unknown route in unknown administration site. On an unknown date, the patient experienced a serious allergic reaction around the spot of the injection (vaccination site hypersensitivity) (Unknown latency) following the administration of POLIOMYELITIS VACCINE (INACTIVATED). On an unspecified date, on Wednesday, patient died. The informed police that after a nurse gave patient the vaccine, they took him home and patient went to sleep. However, patient did not wake up in the morning. When they took the infant to a hospital, a doctor informed that the patient had died, said Police Inspector. Allergic reaction around the spot of the injection was observed by the parents. The reporter lodged a complaint with the police alleging that his son died because of the vaccination. The patient body was shifted to Hospital mortuary for post-mortem. A case under (Causing death by negligence) had been registered. The issue had come the notice of the Health Department officials. They would go through the post-mortem report to knew cause of death. (Other relevant tests included no lab data.) Final diagnosis was death NOS and allergic reaction around the spot of the injection. It was not reported if the patient received a corrective treatment. The patient outcome was unknown for allergic reaction around the spot of the injection. It is unknown if an autopsy was done. The cause of death was not reported. List of documents held by sender: none.; Sender''s Comments: In this case, a 3-month-old male patient received a dose of POLIOMYELITIS VACCINE (INACTIVATED) produced by unknown manufacturer and went back home. The patient did not wake up in the morning, and was brought to the hospital and declared death. As per parents, allergic reaction at injection site (reported as injection site hypersensitivity) was observed. Medical history was not provided. The time to onset is unknown. Autopsy result was not available. Moreover, patient''s medical condition at the time of vaccination was not reported. Based upon the reported information, the role of vaccine cannot be assessed; Reported Cause(s) of Death: patient had died


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