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This is VAERS ID 842275

Case Details

VAERS ID: 842275 (history)  
Form: Version 2.0  
Sex: Unknown  
Location: Foreign  
Submitted: 0000-00-00
Entered: 2019-10-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: ?
Symptoms: Chronic obstructive pulmonary disease, Condition aggravated, Death

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: End stage COPD
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: ESPFIZERINC2019451420

Write-up: Progression of COPD disease. Cause of death unknown This is a report from a Non-Interventional Study source. A subject of unspecified age and gender received pneumococcal 13-val conj vac (dipht crm197 protein) (PREVENAR 13), via an unspecified route of administration, on an unspecified date, at single dose, for immunisation. The subject had COPD stage IV Gold D with very severe disease and other comorbidities. Concomitant medications were not reported. The subject previously took pneumococcal vaccine for immunization on 21Oct2016. The subject experienced progression of COPD disease, cause of death unknown on an unspecified date. It was unknown if an autopsy was performed. The information on the lot/batch number has been requested. Event occurred in a country different from that of the reporter. This may be a duplicate if the reporter also submitted directly to his/her local agency. The reporter''s assessment of the causal relationship of the event with the suspect product was not provided at the time of this report. Since no determination has been received, the case is managed based on the company causality assessment.; Sender''s Comments: There is no reasonable possibility that the event death was related to pneumococcal 13-valent conjugate vaccine. This is more likely associated with the progression of the underlying COPD.; Reported Cause(s) of Death: Cause of death unknown

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