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This is VAERS ID 150596

(NOTE: This result is from the 12/30/2006 version of the VAERS database)

Case Details

VAERS ID: 150596 (history)  
Form: Version .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: UNK. HAEMOPHILUS B / UNCLASSIFIED - / 0 - / IM
MEN: UNK. MENINGOCOCCAL POLYSACCHARIDE / UNCLASSIFIED - / 0 - / SC
PPV: PNU-IMUNE(R)23 / LEDERLE 463727 / 0 - / -

Administered by: Private       Purchased by: Unknown
Symptoms: CEREBROVASC ACCID, MYELOMA
SMQs:

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:

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 emerge"ncy 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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