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This is VAERS ID 838299

History of Changes from the VAERS Wayback Machine

First Appeared on 2/14/2020

VAERS ID: 838299
VAERS Form:2
Age:56.0
Sex:Female
Location:Foreign
Vaccinated:2019-01-16
Onset:2019-09-01
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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2019-09-01
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': 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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