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From the 6/14/2018 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 1.0  
Age: 1.1  
Sex: Female  
Location: Unknown  
   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

Administered by: Private       Purchased by: Other
Symptoms: Antimicrobial susceptibility test, Blood culture positive, Brain death, CSF culture positive, Culture urine positive, Death, Intensive care, Pneumococcal bacteraemia, Respiratory failure, Septic shock, Vaccination failure
SMQs:, Anaphylactic reaction (broad), Agranulocytosis (broad), Lack of efficacy/effect (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (broad)

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.
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 eight hours); and blood culture (results: pneumococcal bacteria). 6/3/08-records received-NM brain-no scintigraphic evidence of intracranial flow. CSF milky appearance. Gram stain many gram-positive coccobacilli. Protein 1020. WBC 73 and RBC 103. C-reactive protein 13.9. Hypothermic, hypocalcemia, hypokalemia and hyperglycemia. Metabolic acidosis. EEG: compatible with electrocerebral silence, no evidence of cortical activity. Blood culture positive for gram positive cocci.
CDC Split Type: USWYEH04198908

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 bacteria 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 and a large amount of pneumococcal bacteria that grew in less than eight hours in CSF culture, which led to the additional diagnosis of pneumococcal meningitis. Serotype testing was not performed. An antimicrobial susceptibility test was unremarkable. The physician felt "like this is a vaccine failure". The patient also developed neurogenic septic shock. Treatment included ROCEPHIN and VANCOMYCIN. On 12-May-2008, the patient died. The cause of death were reported as meningitis pneumococcal, respiratory failure, septic shock, vaccination failure, brain death and pneumococcal sepsis. No additional information was available at the time of this report. 6/3/08-records received for DOS 5/11-5/13/08-Date of Death 5/13/08. Final DX: Meningitis secondary to Streptococcus pneumoniae. Gram-positive coccal bacteremia. Admission neurologic examination consistent with brain death, subsequently confirmed. Brain death confirmed by repeat examination and confirmatory tests through course of hospitalization. Admitted via emergency room previously well child until 3/10/08, warm to touch temperature 101, listless and febrile with temperature as high as 104.4. Vomited. Became limp, feet cold, apneic. CPR initiated at home. Cyanotic. Pupils dilated and nonreactive. GCS 3. Heart rate 170 but not palpable pulses. No spontaneous respirations. Intubation, mechanical ventilation.

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