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This is VAERS ID 818508

Case Details

VAERS ID: 818508 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Foreign  
Vaccinated:2017-10-03
Onset:2019-03-20
   Days after vaccination:533
Submitted: 0000-00-00
Entered: 2019-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEN: MENINGOCOCCAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -
MEN: MENINGOCOCCAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 - / -
MEN: MENINGOCOCCAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 3 - / -

Administered by: Other       Purchased by: ?
Symptoms: Death, Meningitis, Neisseria test positive, Vaccination failure
SMQs:, Lack of efficacy/effect (narrow), Noninfectious meningitis (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2019-03-20
   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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: Serology test; Result Unstructured Data: Test Result: Serogroup B positive, Test Result Unit: unknown
CDC Split Type: IEGLAXOSMITHKLINEIE2019EM

Write-up: Vaccination failure; Meningitis B; This case was reported by a other health professional and described the occurrence of vaccination failure in a 19-month-old female patient who received Men B NVS (Meningococcal B vaccine) for prophylaxis. Co-suspect products included Men B NVS (Meningococcal B vaccine) for prophylaxis and Men B NVS (Meningococcal B vaccine) for prophylaxis. On 3rd October 2017, the patient received the 1st dose of Meningococcal B vaccine. On 17th December 2017, the patient received the 2nd dose of Meningococcal B vaccine. On 3rd August 2018, the patient received the 3rd dose of Meningococcal B vaccine. On 20th March 2019, 1 year and 168 days after receiving Meningococcal B vaccine, 1 year and 93 days after receiving Meningococcal B vaccine and 229 days after receiving Meningococcal B vaccine, the patient experienced vaccination failure (serious criteria GSK medically significant) and meningitis (serious criteria death and GSK medically significant). On an unknown date, the outcome of the vaccination failure was unknown and the outcome of the meningitis was fatal. The patient died on 20th March 2019. The reported cause of death was meningitis. It was unknown if the reporter considered the vaccination failure and meningitis to be related to Meningococcal B vaccine, Meningococcal B vaccine and Meningococcal B vaccine. Additional details were provided as follows: The age at vaccination was not provided. There had been Men B vaccine failure reported recently this year till the day of reporting This case was linked to case IE2019EME102212 reporter by same reporter. Lab Comments: Lab test performed on an unknown date; Reported Cause(s) of Death: Meningitis


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