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This is VAERS ID 837422

History of Changes from the VAERS Wayback Machine

First Appeared on 2/14/2020

VAERS ID: 837422
VAERS Form:2
Age:
Sex:Male
Location:Foreign
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:2019-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PPV: PNEUMO (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Death, Respiratory failure

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': CO0095075131910COL000725

Write-up: RESPIRATORY FAILURE; This spontaneous report was received from an Agency and refers to a 2-year-old male patient. The patient''s medical history, concurrent conditions and concomitant drugs were not provided. On an unknown date, the patient was vaccinated with pneumococcal vaccine, polyvalent (23-valent) (manufacturer unknown) dose reported as 4 (units not reported) (route, site of administration, lot# and expiration date were not reported) for prophylaxis. On an unknown date, the patient experienced respiratory failure. On an unknown date, the patient died due to the event. It was unknown if an autopsy was performed. The relatedness between the event and pneumococcal vaccine, polyvalent (23-valent) (manufacturer unknown) was not reported.

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