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From the 12/8/2009 release of VAERS data (an older release, current is 4/1/2021):

This is VAERS ID 25556

Case Details

VAERS ID: 25556 (history)  
Form: Version .0  
Sex: Female  
Location: New York  
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 1990-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 42622/1644R / - - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1989-10-25
   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: no relevant history
Preexisting Conditions:
Diagnostic Lab Data: autopsy-strep sepsis, The physician & autopsy pathologist felt that the pt''s dealth was not related to vaccination.
CDC Split Type: WAES89100782

Write-up: MD reported pt initially vac. w/ MMR live at 15 mo''s was vac. w/ booster MMR on 10-20-89 along w/ DTP. Pt died 10-25-89. Autopsy = overwhelming strep. sepsis. MD and autopsy pathologist felt pt death not related to vaccination.

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