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From the 12/30/2020 release of VAERS data (an older release, current is 11/12/2021):

This is VAERS ID 382971

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Case Details

VAERS ID: 382971 (history)  
Form: Version 1.0  
Age: 10.0  
Sex: Female  
Location: Foreign  
   Days after vaccination:20
Submitted: 2010-03-18
   Days after onset:140
Entered: 2010-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Basophil percentage decreased, Blood smear test abnormal, Death, Eosinophil percentage, Haemoglobin decreased, Headache, Lymphocyte percentage, Malaria, Monocyte percentage decreased, Neutrophil percentage increased, Pyrexia, White blood cell count increased
SMQs:, Haematopoietic erythropenia (broad), Haematopoietic leukopenia (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2009-10-30
   Days after onset: 1
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: Basophils, 30Oct2009, 0%; Blood smear test, 30Oct2009, Positive; Eosinophils, 30Oct2009, 1%; Hemoglobin, 30Oct2009, 4g/dl; Lymphocytes, 30Oct2009, 28%; Monocytes, 30Oct2009, 0%; Neutrophils, 30Oct2009, 71%; White blood cell count, 30Oct2009, 46200/mm3
CDC Split Type: B0639818A

Write-up: This case was reported by a healthcare professional and described the occurrence of malaria in a 10-year-old female subject who was vaccinated with CERVARIX (GlaxoSmithKline). Previous and/or concurrent vaccination included CERVARIX; GlaxoSmithKline; intramuscular; left deltoid given on 2 September 2009. On 9 October 2009, the subject received 2nd dose of CERVARIX (intramuscular, left deltoid). No adverse event was reported during the observation period of 30 minutes after each dose of CERVARIX. The subject migrated to another village with her parents. She was in good condition and doing well. On 29 October 2009, 1 month after vaccination with the 2nd dose of CERVARIX, the subject experienced severe headache and fever. She visited a private local clinic for treatment as an outdoor patient. The subject was given an injection of an unspecified drug in the right upper arm by the physician. Malaria was suspected and a blood test was prescribed. Unspecified medication was also provided by the physician. On 30 October 2009, the subject was brought to the hospital in critical condition. The laboratory test on blood showed low hemoglobin level 4g/dl which is only 27.58% of a normal level, white blood cells 46200/mm3 with 71% neutrophils, 28% lymphocytes, 1% eosinophils, 0% monocytes and 0% basophils. The thin and thick blood smear analysis revealed many rings of trophozoites and schizont of plasmodium Vivax. The diagnosis of malaria was made. The subject was sent to the community health center where a treatment was started. Around 1 hour later, the subject was declared dead. The subject died on 30 October 2009 from malaria. An autopsy was not performed.

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