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From the 12/31/2008 release of VAERS data (an older release, current is 1/7/2022):

This is VAERS ID 314292

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Case Details

VAERS ID: 314292 (history)  
Form: Version .0  
Age: 1.1  
Sex: Female  
Location: Unknown  
Vaccinated:2008-05-05
Onset:2008-05-11
   Days after vaccination:6
Submitted: 2008-05-29
   Days after onset:18
Entered: 2008-05-30
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC C57543 / 3 UN / UN

Administered by: Private       Purchased by: Unknown
Symptoms: Antimicrobial susceptibility test, Apnoea, Blood culture positive, Body temperature increased, Brain death
SMQs:, Neuroleptic malignant syndrome (broad), Acute central respiratory depression (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2008-05-13
   Days after onset: 2
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Concomitant medications were not reported.
Current Illness: Unknown
Preexisting Conditions: The patient had no notable medical history. The child went to daycare. 6/3/08-records received-PMH: Roseola at age 7 months. weight loss.
Allergies:
Diagnostic Lab Data: Antimicrobial susceptibility test (results: unremarkable) was done in May-2008. On 11-May-2008 test results were: culture urine (results: pneumococcal bacteria); CSF culture (results: grew large amount of pneumococcal bacteria in less than
CDC Split Type:

Write-up: Information regarding PREVNAR was received from a physician regarding a female patient who received the fourth dose on 05-May-2008 at 12 months of age and experienced neurogenic septic shock, neurogenic respiratory failure, brain dead, pneumococcal bacter"ia in blood, vaccine failure and pneumococcal meningitis at 13 months of age. On 11-May-2008, the patient was admitted to the intensive care unit brain dead and in neurogenic respiratory failure. Laboratory results revealed pneumococcal bacteria in blood


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