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This is VAERS ID 837802

History of Changes from the VAERS Wayback Machine

First Appeared on 2/14/2020

VAERS ID: 837802
VAERS Form:2
Age:
Sex:Male
Location:Foreign
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:2019-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 4 - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Death, Septic shock

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': CO0095075131910COL002350

Write-up: Septic shock; Information has been received a from Health Authority (agency number was not provided) on 20-SEP-2019. This spontaneous report was received from a Health Authority, concerning to a 2-year-old, male patient. Information about medical history, concurrent conditions and concomitant medications was not provided. On an unknown date, the patient was vaccinated with the fourth dose of hepatitis a vaccine, inactivated (manufacturer unknown) (reported as hepatitis A purified antigen) (strength, formulation, dose, anatomical location of vaccination, route of administration, indication, lot number and expiration date were not reported). On an unknown date, the patient experienced septic shock and and consequently the patient died. The causality assessment between therapy with hepatitis a vaccine, inactivated (manufacturer unknown) and the aforementioned event was not reported.

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