This is VAERS ID 473483

(NOTE: This result is from the 2/14/2018 version of the VAERS database)

Case Details

VAERS ID:	473483 (history)
Form:	Version 1.0
Age:	31.0
Sex:	Male
Location:	Oklahoma

Vaccinated:	2012-10-30
Onset:	2012-10-31
Days after vaccination:	1
Submitted:	2012-11-07
Days after onset:	7
Entered:	2012-11-07

Vaccination / Manufacturer	Lot / Dose	Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS	AHAVB566AN / UNK	LA / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR	H1354 / UNK	LA / IM
TYP: TYPHOID LIVE ORAL TY21A (VIVOTIF) / BERNA BIOTECH, LTD.	3000128 / UNK	MO / PO
YF: YELLOW FEVER (YF-VAX) / SANOFI PASTEUR	UH296AB / UNK	LA / SC

Administered by: Private Purchased by: Private
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 2012-10-31
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: Soma
Current Illness: No
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pronounced dead at home in bed.

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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20180214&IDNUMBER=473483