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This is VAERS ID 836320

Case Details

VAERS ID: 836320 (history)  
Form: Version 2.0  
Age: 2.0  
Sex: Male  
Location: Foreign  
Submitted: 0000-00-00
Entered: 2019-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: CO0095075131909COL011156

Write-up: death; This spontaneous report has been received from regulatory authority, concerning to a 2 year old male patient. The patient''s concurrent conditions, historical conditions, previous drug reactions, or allergies and concomitant medication were not reported. On an unknown date, the patient was vaccinated with varicella virus vaccine live (oka/merck)(manufacturer unknown) frequency, dose, lot number, anatomical location and expiration date were not reported) for prophylaxis. After the vacciantion the patient died. It was not reported the cause of death, and if an autopsy was performed. The reporter considered the death to be related to varicella virus vaccine live (oka/merck)(manufacturer unknown).

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