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Found 334 cases where Vaccine is 6VAX-F or DT or DTAPH or DTAPHEPBIP or DTAPIPV or DTAPIPVHIB or DTIPV or DTP or DTPHIB or DTPIHI or DTPIPV or DTPPHIB or TD or TDAP or TTOX and Patient Died and Vaccination Date from '2001-01-01' to '2008-12-31'

Table

   
AgeCountPercent
< 3 Years28785.93%
3-6 Years20.6%
6-9 Years10.3%
9-12 Years10.3%
12-17 Years30.9%
17-44 Years144.19%
44-65 Years113.29%
65-75 Years51.5%
75+ Years41.2%
Unknown61.8%
TOTAL334100%

Case Details

This is page 1 out of 34

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VAERS ID: 169020 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Male  
Location: Illinois  
Vaccinated:2001-04-17
Onset:2001-04-18
   Days after vaccination:1
Submitted: 2001-06-06
   Days after onset:49
Entered: 2001-04-25
   Days after submission:42
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 470527 / UNK RL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH 582953A / UNK RL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. T0266 / UNK LL / IM

Administered by: Private       Purchased by: Private
Symptoms: Cardiac failure congestive, Congenital megacolon, Oesophagitis, Sudden infant death syndrome
SMQs:, Cardiac failure (narrow), Congenital, familial and genetic disorders (narrow), Gastrointestinal nonspecific inflammation (narrow), Cardiomyopathy (broad), Neonatal disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2001-04-18
   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: Patient had uneventful birth 02/05/01. Sister had strep infection 3 WEEKS AGO BUT THE BABY DID NOT GET SICK.
Allergies:
Diagnostic Lab Data: Autopsy findings: Hirschprung''s disease, acute congestive heart failure, chronic esophagitis
CDC Split Type: U2001006400

Write-up: It was reported that a 2 month old healthy male infant was vaccinated on 4/17/01 with IPOL, DPT and Hib-Titer. Reportedly, the parents found the baby dead in the morning of 4/18/2001. An autopsy is being performed. Sudden Infant Death reported. Autopsy report findings: Hirschsprung''s disease.


VAERS ID: 181512 (history)  
Form: Version 1.0  
Age: 1.5  
Sex: Male  
Location: Indiana  
Vaccinated:2002-01-17
Onset:2002-01-19
   Days after vaccination:2
Submitted: 2002-02-11
   Days after onset:23
Entered: 2002-02-20
   Days after submission:9
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPH: DTAP + HIB (TRIHIBIT) / SANOFI PASTEUR 3274C / 4 RL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / SANOFI PASTEUR U03442 / 3 LA / SC
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1094L / 1 RA / SC
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH 488175 / 2 LL / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1235L / 1 LA / SC

Administered by: Private       Purchased by: Public
Symptoms: Coma, Petechiae
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2002-01-19
   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: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy-pending Autopsy states; few petechiae of heart, thymus and lungs; early stage of decompression; no evidence of injuries; cultures are neg for pathologic organisms; blood neg for volatiles, acetaminophen and CO; blood salicylate 11.2ug/ml; urine neg for drugs
CDC Split Type:

Write-up: Informed by mom on 2/8/02 that her child was found dead in bed on 1/19/02 about 33 hours after well child visit and immunizations. No previous by us, last immunizations at 6 months. Mom reports an autopsy is being done. Per coroner''s office no autopsy was done in this county. COD as per autopsy report is undetermined. Info rec''d 4/18/02 states; The decedent was an 18 month old white male who lived with his parents. He was pronounced nonviable by medics at 08:55 upon their arrival at the residence. The child was found by his father around 08:45 to be unresponsive and 911 was called. The child was last seen alive by his mother about 23:00 of the night before when she placed him in bed after returning from a birthday party. The child has a clinic visit on 1/17 when he had 5 immunization shots and treatment for dry skin rash. There was bottles of children liquid cold medicine scattered in the kitchen but according to the mother, the infant had not had any since the last time he was sick, about 2 1/2 weeks ago. COD: undetermined.


VAERS ID: 183160 (history)  
Form: Version 1.0  
Age: 32.0  
Sex: Female  
Location: California  
Vaccinated:2002-03-21
Onset:2002-03-22
   Days after vaccination:1
Submitted: 2002-03-30
   Days after onset:8
Entered: 2002-04-04
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 13844 / UNK - / SC
TD: TD ADSORBED (NO BRAND NAME) / SANOFI PASTEUR U0519AA / UNK - / IM

Administered by: Private       Purchased by: Private
Symptoms: Respiratory disorder
SMQs:, Acute central respiratory depression (broad), Respiratory failure (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2002-05-01
   Days after onset: 39
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: At 17:00 on 3/21/02, she received MMR and Tetanus vaccination. About 12 hours later (05:00 on 3/22/02), she died and was brought back. 05/01/2002 patient expired after being transferred to hospital in Budapest. Records from San Clemente Hospital: Diagnosed with severe anoxic brain injury, probably alpha coma, seizure disorder, staphylococcus aureus bronchitis, ventricular fibrillation arrest, tachycardia, elevated liver enzymes.


VAERS ID: 188844 (history)  
Form: Version 1.0  
Age: 88.0  
Sex: Male  
Location: New York  
Vaccinated:2002-08-06
Onset:2002-08-06
   Days after vaccination:0
Submitted: 2002-08-09
   Days after onset:3
Entered: 2002-08-14
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
TD: TD ADSORBED (NO BRAND NAME) / SANOFI PASTEUR U0382AA / UNK LA / IM

Administered by: Public       Purchased by: Public
Symptoms: Apnoea, Circulatory collapse
SMQs:, Anaphylactic reaction (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Torsade de pointes, shock-associated conditions (narrow), Hypovolaemic shock conditions (narrow), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypoglycaemic and neurogenic shock conditions (narrow), Acute central respiratory depression (narrow), Hypersensitivity (narrow), Respiratory failure (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2002-08-06
   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: Proscar, Docusate, Calcium, Prilosec, Multivitamin, Flomax, Tylenol, Carafate, Reglan, Cozaar, Ferrous sulfate, Lasix 80mg qd and Lasix 40mg qd
Current Illness: NONE
Preexisting Conditions: CHF, Hiatal Hernia, acid reflux, arthritis, hypertension, enlarged prostate, CAD
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type: NYS22006

Write-up: Pt was sitting at a table and started to get up, suddenly collapsed and stopped breathing. Pt was a resident of an assisted living facility and was a DNR so facility staff did not attempt CPR. Pt was transported to ER where he was pronounced dead.


VAERS ID: 199949 (history)  
Form: Version 1.0  
Age: 42.0  
Sex: Male  
Location: Indiana  
Vaccinated:2003-03-06
Onset:2003-03-06
   Days after vaccination:0
Submitted: 2003-03-18
   Days after onset:12
Entered: 2003-03-20
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
TD: TD ADSORBED (NO BRAND NAME) / SANOFI PASTEUR 00550AA / UNK - / IM

Administered by: Other       Purchased by: Other
Symptoms: Atherosclerosis, Cardiovascular disorder, Dizziness, Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2003-03-11
   Days after onset: 5
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ephedra
Current Illness:
Preexisting Conditions: Patient was a Tetanus plasma donor and had donated a unit of Source plasma (approximately 10 mL on 03/06/2003. He had participated in the Tetanus Immune Plasma program in the past and had donated plasma regularly since 2001 (125 times prior to the 03/06/2003 donation) and each time without incident. Pt had a physical on 02/19/2003 that indicated that he was a healthy and suitable donor. The pt''s health history was unremarkable and showed that the pt had pneumonia in 1979, a tonsil and adenoid removal in 1968, and surgery on his right knee in 1976. Per the pt''s brother, he may have been taking Mini-thins, a dietary supplement containing ephedra, which he had taken in the past and had lost weight due to the fact that he had been walking 2 miles to and from work each day.
Allergies:
Diagnostic Lab Data: Vital signs included pulse-86; BP-153/79; temperature-99.0F; hematocrit-43 and total protein 7.5 were all WNL.
CDC Split Type: U200300083

Write-up: From initial correspondence received at manufacturer, on 03/11/2003 it was reported that a 42-year-old male pt who was a Tetanus Plasma Donor, received a Tetanus Toxoid Adsorbed vaccination, administered IM in the right deltoid on 03/06/2003. The pt was observed for 15 minutes post-vaccination and was fine Pt has no history of allergies to Tetanus. Reportedly the pt passed away on 03/06/2003 or 03/07/2003, this is still under investigation. According to further info received on 03/12/2003 frm reporter it was reported: "The donor (the patient) successfully and without incident donated a unit of Source Plasma on 03/06/2003, was found dead in his bed on either March 6 or 7, 2003. There appears to be no relationship between the donor''s death and his donation of plasma on the previous day. In a telephone conversation with the Coroner''s office this morning, March 12th, Aventis Bio Services were informed that the cause of death in this case was due to severe Atherosclerotic Cardiovascular Disease." "The decedent was a 42-year-old male who was a regular donor. He weighed 166 pounds, and had donated a unit of Source Plasma (approximately 30 mL) on 03/06/2003 between approximately 6:30 AM and 9:30 AM. The donor''s vital signs, including his pulse (86), blood pressure (153/79), temperature (99.0 F), hematocrit (43) and total protein (7.5) were all within acceptable limits. Info obtained during annual physical examinations conducted on this donor on 02/19/2003 indicated that he was healthy and suitable to donate. On 03/10/2003, manufacturer was contacted by the donor''s brother and was informed that when the donor returned home sometime after donating that he complained of lightheadedness and numbness below the elbows in both arms. The brother reported inquiring if medical care was needed but the donor declined and elected to ''lay down for a while and try to feel better.'' The donor''s brother reported that when he tried to wake the donor on either Thursday afternoon or evening or Friday morning, that the donor had passed away. The decedent''s brother speculated that the donor might have taken the dietary supplement ''Minithins'' which contain ephedra since he had known him to take the supplement in the past. An autopsy was performed; a copy of the post-mortem report will be forwarded to manufacturer. The cause of death was reported by the Indiana Coroner''s Office on 03/12/2003 to manufacturer as being due to severe atherosclerotic cardiovascular disease.


VAERS ID: 202332 (history)  
Form: Version 1.0  
Age: 22.0  
Sex: Male  
Location: Texas  
Vaccinated:2003-02-01
Onset:2003-02-06
   Days after vaccination:5
Submitted: 2003-04-28
   Days after onset:80
Entered: 2003-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ANTH: ANTHRAX (BIOTHRAX) / EMERGENT BIOSOLUTIONS - / 2 - / -
HEP: HEP B (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -
HEPA: HEP A (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR - / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -
SMALL: SMALLPOX (DRYVAX) / PFIZER/WYETH 4020071 / 1 - / -
TD: TD ADSORBED (NO BRAND NAME) / SANOFI PASTEUR - / UNK - / -

Administered by: Military       Purchased by: Military
Symptoms: Coma, Hypertrophy
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2003-02-06
   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: See tox screening in box 7.
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: See box 7.
CDC Split Type:

Write-up: Active-duty soldier, 181 cm tall, 180 lbs, found unresponsive in barracks 5-6 days post smallpox vaccination. Post-mortem toxicology positive for methadones (0.26 mg/L), diazepam (0.33 mg/L), nordiazepam (0.22 mg/L), but not temazepam, alprazolam, or dextromethorphan. Autopsy revealed concentric L ventricular hypertrophy, but no myocarditis. Conclusion: Vaccination unrelated to soldier''s death.


VAERS ID: 206796 (history)  
Form: Version 1.0  
Age: 0.18  
Sex: Male  
Location: California  
Vaccinated:2003-07-21
Onset:2003-07-23
   Days after vaccination:2
Submitted: 2003-07-24
   Days after onset:1
Entered: 2003-07-30
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS 21885B9 / 1 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UA853AA / 1 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH 491183 / 1 RL / IM

Administered by: Private       Purchased by: Private
Symptoms: Unevaluable event
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2003-07-23
   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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy pending
CDC Split Type:

Write-up: Patient received vaccines on 7/21. Patient expired during the night of 7/22-23. Do not know if expired before or after midnight of 7/22.


VAERS ID: 207693 (history)  
Form: Version 1.0  
Age: 56.0  
Sex: Male  
Location: Ohio  
Vaccinated:2003-07-29
Onset:2003-07-29
   Days after vaccination:0
Submitted: 2003-07-29
   Days after onset:0
Entered: 2003-08-12
   Days after submission:14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 0256N / 1 LA / IM
TD: TD ADSORBED (NO BRAND NAME) / SANOFI PASTEUR U0839AA / UNK RA / IM

Administered by: Private       Purchased by: Private
Symptoms: Arteriosclerosis, Cardiac arrest
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (broad), Cardiomyopathy (broad), Respiratory failure (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2003-07-29
   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:

Write-up: Follow up received on 08/22/2003: "I am responding to your VAERS request regarding the patient, who died on 07/29/2003. An autopsy was performed at our facility; however, the cause and manner of death are ruled as pending at this time. A copy of the autopsy will be forwarded to you upon its completion."


VAERS ID: 207831 (history)  
Form: Version 1.0  
Age: 0.33  
Sex: Male  
Location: Florida  
Vaccinated:2003-07-23
Onset:2003-07-26
   Days after vaccination:3
Submitted: 2003-08-11
   Days after onset:16
Entered: 2003-08-14
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS 21881E9 / 2 RL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0255N / 2 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH 492856 / 2 LL / IM

Administered by: Public       Purchased by: Public
Symptoms: Sudden infant death syndrome
SMQs:, Neonatal disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2003-07-26
   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: NONE
Preexisting Conditions: Prematurity; No prenatal care; Jaundice; GERD
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: Impression: SIDS. This case was reported by a nurse and described an infant who died after receiving diphtheria and tetanus toxoids and acellular pertussis absorbed, hepatitis B recombinant and inactivated poliovirus vaccine combined for prophylaxis. The vaccine provider submitted a report directly to VAERS. The patient''s past medical history included premature birth at 34 weeks'' gestation; there had been no prenatal care. The medical history also included gastric reflux. Concurrent medications were not reported. On 7/21/03 the patient received an injection of Pediarix (lot 21881E9), as well as, other unspecified vaccines. Three days post immunization, on 7/26/03, the patient died. Cause of death was unknown. An autopsy was performed; the results were not available as of 8/13/03. Death certificate confirms the cause of death as SIDS. - 10/16/2003 autopsy report rec''d. COD confirmed as SIDS.


VAERS ID: 207832 (history)  
Form: Version 1.0  
Age: 0.14  
Sex: Female  
Location: Florida  
Vaccinated:2003-08-05
Onset:2003-08-06
   Days after vaccination:1
Submitted: 2003-08-11
   Days after onset:5
Entered: 2003-08-14
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS 21881E9 / 1 RL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0255N / 1 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH 492856 / 1 LL / IM

Administered by: Public       Purchased by: Public
Symptoms: Sudden infant death syndrome
SMQs:, Neonatal disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2003-08-06
   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: NONE
Preexisting Conditions: Thrush
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Impression: SIDS. 9/3/03 Per review of autopsy report, final COD was confirmed as SIDS.


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