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This is VAERS ID 150596

Case Details

VAERS ID: 150596 (history)  
Form: Version 1.0  
Age: 60.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2000-02-09
Onset:2000-02-09
   Days after vaccination:0
Submitted: 2000-03-28
   Days after onset:48
Entered: 2000-03-30
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / IM
MEN: MENINGOCOCCAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / SC
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 463727 / 1 - / -

Administered by: Private       Purchased by: Other
Symptoms: Cerebrovascular accident
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2000-02-15
   Days after onset: 6
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: HQ1812624MAR2000

Write-up: Pt with a history of multiple myeloma received injections of Pnu-Imune 23, Act-HIB (Aventis Pasteur SA) and Menomune-a/c/y/w 135 (Aventis Pasteur Inc) vaccines on 9-FEB-2000. Later that day he experienced "stroke-like symptoms" and was brought to emergency room. After extensive testing it was determined he had an embolic stroke and the reporter did not feel it was related to the vaccines.


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