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This is VAERS ID 837503

Case Details

VAERS ID: 837503 (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
HEPA: HEP A (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: CO0095075131910COL001278

Write-up: vaccination complication; This spontaneous report was received from the Regulatory Authority, concerning a 2-year-old male patient. The patient''s pertinent medical history, concurrent conditions, concomitant medications, previous drug reactions or allergies were not reported. On an unknown date, the patient started therapy with hepatitis A vaccine, inactivated (manufacturer unknown) (dose, route of administration, frequency, indication, lot number and expiration date were not reported). Dose reported as 4. On an unknown date, the patient experienced vaccination complication and died. It was not reported if an autopsy was performed. The relatedness between hepatitis A vaccine, inactivated (manufacturer unknown) and the aforementioned event was not reported.; Reported Cause(s) of Death: vaccination complication


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