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This is VAERS ID 838299

Case Details

VAERS ID: 838299 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Foreign  
Vaccinated:2019-01-16
Onset:2019-09-01
   Days after vaccination:228
Submitted: 0000-00-00
Entered: 2019-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2019-09-01
   Days after onset: 0
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: CLPFIZER INC2019425849

Write-up: patient died; This is a spontaneous report from a contactable nurse. A 57-year-old female patient received a single dose of pneumococcal 13-val conj vac (dipht crm197 protein) (PREVENAR 13) for immunization on 16Jan2019, when she was 56 years old. The patient medical history and concomitant medications were not reported. The patient died on an unknown date in Sep2019. Cause of death was unknown. It was not reported if an autopsy was performed. Information on lot number has been requested.; Sender''s Comments: There is no information in the case suggesting a possible contribution of pneumococcal 13-valent conjugate vaccine to the reported death.; Reported Cause(s) of Death: patient died


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