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This is VAERS ID 25520

(NOTE: This result is from the 5/14/2017 version of the VAERS database)

Case Details

VAERS ID: 25520 (history)  
Form: Version .0  
Age: 71.0  
Sex: Male  
Location: Unknown  
Vaccinated:1988-02-03
Onset:1990-02-17
   Days after vaccination:745
Submitted: 0000-00-00
Entered: 1990-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / - - / IM

Administered by: Private       Purchased by: Unknown
Symptoms: Sepsis
SMQs:, Agranulocytosis (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1990-02-17
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Tolbutamide, Vitamin B, Vitamin C
Current Illness: Presenile dementia; Diabetes mellitus
Preexisting Conditions: Renal dialysis; Renal failure
Allergies:
Diagnostic Lab Data:
CDC Split Type: WAES90060030

Write-up: 71 yr old male w/presenile dementia, diabetes mellitus, & renal failure received Hepatitis B vaccine, recombinant, 40 mcg, IM. Dialysis shunt became infected Dx w/sepsis therapy initiated w/flucloxacillin, however pt died that day.


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