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This is VAERS ID 473483

(NOTE: This result is from the 10/14/2018 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=20181014&IDNUMBER=473483


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