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This is VAERS ID 837502

Case Details

VAERS ID: 837502 (history)  
Form: Version 2.0  
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, Vaccination complication
SMQs:

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: CO0095075131910COL001167

Write-up: vaccination complication; Information has been received from the Regulatory Authority on 20-SEP-2019, concerning a 2-year-old male patient. The patient''s medical history, concurrent conditions and concomitant medications were not reported. On an unknown date, the patient was vaccinated with an unspecified pneumococcal vaccine (reported as "pneumococo purified conjugated polycharized antigens") (manufacturer unknown), dose reported as 4 (units not reported), for prophylaxis (route of administration, lot number and expiration date were not reported). On an unknown date, the patient experienced vaccination complication. On an unknown date, he died due to the event. It was not reported if an autopsy was performed. The causal relationship between the suspect vaccine and the event was not reported.; Reported Cause(s) of Death: vaccination complication


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