This is VAERS ID 1975356

Administered by: Other       Purchased by: ?
Symptoms: Autopsy, Cough, Exposure to communicable disease, Influenza virus test positive, Pyrexia, Respiratory arrest, Respiratory tract congestion, Resuscitation, SARS-CoV-2 test negative, Unresponsive to stimuli
SMQs:, Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-12-10
   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: None
Current Illness: Fever, vomiting on 11/25 - lasted 24-48 hours Other family members had similar symptoms
Preexisting Conditions: None
Allergies: None known
Diagnostic Lab Data: COVID pcr negative 12/9/2021
CDC Split Type:

Write-up: Patient developed fever on 12/9/2021, with mild cough and congestion. Was treated at home with acetaminophen at approximately 12:30 pm, ibuprofen at 7:30 pm. Entire family was sick with similar symptoms. 2 siblings were positive for influenza and strep, Patient was not tested for either of those. 12/9 had a COVID pcr test done - negative. On 12/10/21 mom went to check on her in the morning at 9:15, found patient n bed, not breathing, unresponsive. Attempted CPR with no response. Final autopsy report pending. Parents report they received a call from medical examiner notifying ten that patient was tested + for influenza on post-mortem.