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This is VAERS ID 864208

History of Changes from the VAERS Wayback Machine

First Appeared on 6/13/2020

VAERS ID: 864208
VAERS Form:2
Age:
Sex:Female
Location:Foreign
Vaccinated:2019-11-28
Onset:2019-12-01
Submitted:0000-00-00
Entered:2020-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Death, Influenza, Vaccination failure, Pneumococcal infection, Antibody test negative

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Prophylactic vaccination
Preexisting Conditions: Medical History/Concurrent Conditions: Decreased immune responsiveness; Poliomyelitis; Comments: Previous Polio patient.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': DK0095075132002DNK010698

Write-up: Pneumococcal infection; Influenza; patient developed influenza despite the influenza vaccine; Every second year throughout many years, antibodies were measured following pneumococcal vaccination, and antibodies were very low already 24 months after the vaccinations; This spontaneous report was received from a general practitioner via an sales representative referring to a 67-year-old female patient. The patient''s medical histories included polio and poor response to vaccines. In 2018, the patient was vaccinated with pneumococcal 4 6b 9v 14 18c 19f 23f conj vaccine (crm197)(PREVENAR). Concurrent condition was not reported. Every second year throughout many years, antibodies were measured following pneumococcal vaccination, and antibodies were very low already 24 months after the vaccinations (antibody test negative). The patient therefore received frequent pneumococcal vaccine, polyvalent (23-valent) (PNEUMOVAX) re-vaccinations since the patient was a high-risk patient. On 28-NOV-2019, the patient was vaccinated with pneumococcal vaccine, polyvalent (23-valent) (PNEUMOVAX) (strength, dose, route, lot #, expiration date and anatomical location were not reported) for prophylaxis. On the same date, the patient was vaccinated with influenza virus vaccine (unspecified) (strength, dose, route, lot #, expiration date and anatomical location were not reported) for prophylactic vaccination. In late December 2019, the patient developed influenza despite influenza virus vaccine (unspecified). The patient was hospitalized due to the influenza and there was a fatal outcome, and the date of death was unknown. At the hospital, a pneumococcal infection was also diagnosed. The outcome of influenza, pneumococcal infection and vaccination failure was fatal. The outcome of antibodies were very low was unknown. If an autopsy was performed and cause of death were unknown. The causality between pneumococcal vaccine, polyvalent (23-valent) (PNEUMOVAX) and the events was unknown. Upon internal review, pneumococcal infection was determined to be medically significant.


Changed on 12/24/2020

VAERS ID: 864208 Before After
VAERS Form:2
Age:
Sex:Female
Location:Foreign
Vaccinated:2019-11-28
Onset:2019-12-01
Submitted:0000-00-00
Entered:2020-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Death, Influenza, Vaccination failure, Pneumococcal infection, Antibody test negative

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Prophylactic vaccination
Preexisting Conditions: Medical History/Concurrent Conditions: Decreased immune responsiveness; Poliomyelitis; Comments: Previous Polio patient.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': DK0095075132002DNK010698

Write-up: Pneumococcal infection; Influenza; patient developed influenza despite the influenza vaccine; Every second year throughout many years, antibodies were measured following pneumococcal vaccination, and antibodies were very low already 24 months after the vaccinations; This spontaneous report was received from a general practitioner via an sales representative referring to a 67-year-old female patient. The patient''s medical histories included polio and poor response to vaccines. In 2018, the patient was vaccinated with pneumococcal 4 6b 9v 14 18c 19f 23f conj vaccine (crm197)(PREVENAR). Concurrent condition was not reported. Every second year throughout many years, antibodies were measured following pneumococcal vaccination, and antibodies were very low already 24 months after the vaccinations (antibody test negative). The patient therefore received frequent pneumococcal vaccine, polyvalent (23-valent) (PNEUMOVAX) re-vaccinations since the patient was a high-risk patient. On 28-NOV-2019, the patient was vaccinated with pneumococcal vaccine, polyvalent (23-valent) (PNEUMOVAX) (strength, dose, route, lot #, expiration date and anatomical location were not reported) for prophylaxis. On the same date, the patient was vaccinated with influenza virus vaccine (unspecified) (strength, dose, route, lot #, expiration date and anatomical location were not reported) for prophylactic vaccination. In late December 2019, the patient developed influenza despite influenza virus vaccine (unspecified). The patient was hospitalized due to the influenza and there was a fatal outcome, and the date of death was unknown. At the hospital, a pneumococcal infection was also diagnosed. The outcome of influenza, pneumococcal infection and vaccination failure was fatal. The outcome of antibodies were very low was unknown. If an autopsy was performed and cause of death were unknown. The causality between pneumococcal vaccine, polyvalent (23-valent) (PNEUMOVAX) and the events was unknown. Upon internal review, pneumococcal infection was determined to be medically significant.


Changed on 12/30/2020

VAERS ID: 864208 Before After
VAERS Form:2
Age:
Sex:Female
Location:Foreign
Vaccinated:2019-11-28
Onset:2019-12-01
Submitted:0000-00-00
Entered:2020-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Death, Influenza, Vaccination failure, Pneumococcal infection, Antibody test negative

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Prophylactic vaccination
Preexisting Conditions: Medical History/Concurrent Conditions: Decreased immune responsiveness; Poliomyelitis; Comments: Previous Polio patient.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': DK0095075132002DNK010698

Write-up: Pneumococcal infection; Influenza; patient developed influenza despite the influenza vaccine; Every second year throughout many years, antibodies were measured following pneumococcal vaccination, and antibodies were very low already 24 months after the vaccinations; This spontaneous report was received from a general practitioner via an sales representative referring to a 67-year-old female patient. The patient''s medical histories included polio and poor response to vaccines. In 2018, the patient was vaccinated with pneumococcal 4 6b 9v 14 18c 19f 23f conj vaccine (crm197)(PREVENAR). Concurrent condition was not reported. Every second year throughout many years, antibodies were measured following pneumococcal vaccination, and antibodies were very low already 24 months after the vaccinations (antibody test negative). The patient therefore received frequent pneumococcal vaccine, polyvalent (23-valent) (PNEUMOVAX) re-vaccinations since the patient was a high-risk patient. On 28-NOV-2019, the patient was vaccinated with pneumococcal vaccine, polyvalent (23-valent) (PNEUMOVAX) (strength, dose, route, lot #, expiration date and anatomical location were not reported) for prophylaxis. On the same date, the patient was vaccinated with influenza virus vaccine (unspecified) (strength, dose, route, lot #, expiration date and anatomical location were not reported) for prophylactic vaccination. In late December 2019, the patient developed influenza despite influenza virus vaccine (unspecified). The patient was hospitalized due to the influenza and there was a fatal outcome, and the date of death was unknown. At the hospital, a pneumococcal infection was also diagnosed. The outcome of influenza, pneumococcal infection and vaccination failure was fatal. The outcome of antibodies were very low was unknown. If an autopsy was performed and cause of death were unknown. The causality between pneumococcal vaccine, polyvalent (23-valent) (PNEUMOVAX) and the events was unknown. Upon internal review, pneumococcal infection was determined to be medically significant.

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