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This is VAERS ID 1012692

History of Changes from the VAERS Wayback Machine

First Appeared on 2/12/2021

VAERS ID: 1012692
VAERS Form:2
Age:1.42
Sex:Female
Location:Minnesota
Vaccinated:2020-10-26
Onset:2020-10-27
Submitted:0000-00-00
Entered:2021-02-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS 49TM3 / 4 RL / IM
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER 2SM24 / 1 RL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. T001208 / 3 LL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH DL2861 / 4 LL / IM

Administered by: Private      Purchased by: ??
Symptoms: Death, Sudden death, Autopsy

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2020-10-27
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: mild URI symptoms the month prior, so didn''t have her vaccines at that time. She came back for vaccines on 10/26/2020.
Preexisting Conditions: none
Allergies: Amoxicillin allergy
Diagnostic Lab Data: She had not been ill, had no testing done prior to her death.
CDC 'Split Type':

Write-up: This child died unexpectedly the following morning in her sleep. She has been diagnosed with SUDC (sudden unexplained death of a child). Preliminary autopsy did not uncover any medical issues or problems. There is further testing being done and it may be a few months before all tests are done and final report is available. I do not submit this event as evidence of the cause of this child''s death. However, I need to report this event as it is not clear whether or not the vaccine(s) are related. I had initially planned to wait until final autopsy results were available, but that is taking very long and I wanted to make this report. I submit it today and can provide final autopsy report when I receive it.


Changed on 5/7/2021

VAERS ID: 1012692 Before After
VAERS Form:2
Age:1.42
Sex:Female
Location:Minnesota
Vaccinated:2020-10-26
Onset:2020-10-27
Submitted:0000-00-00
Entered:2021-02-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS 49TM3 / 4 RL / IM
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER 2SM24 / 1 RL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. T001208 / 3 LL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH DL2861 / 4 LL / IM

Administered by: Private      Purchased by: ??
Symptoms: Death, Sudden death, Autopsy

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2020-10-27
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: mild URI symptoms the month prior, so didn''t have her vaccines at that time. She came back for vaccines on 10/26/2020.
Preexisting Conditions: none
Allergies: Amoxicillin allergy allergy
Diagnostic Lab Data: She had not been ill, had no testing done prior to her death.
CDC 'Split Type':

Write-up: This child died unexpectedly the following morning in her sleep. She has been diagnosed with SUDC (sudden unexplained death of a child). Preliminary autopsy did not uncover any medical issues or problems. There is further testing being done and it may be a few months before all tests are done and final report is available. I do not submit this event as evidence of the cause of this child''s death. However, I need to report this event as it is not clear whether or not the vaccine(s) are related. I had initially planned to wait until final autopsy results were available, but that is taking very long and I wanted to make this report. I submit it today and can provide final autopsy report when I receive it.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1012692&WAYBACKHISTORY=ON


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