National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 9/17/2021 release of VAERS data:

This is VAERS ID 289148



Case Details

VAERS ID: 289148 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Male  
Location: Alabama  
Vaccinated:2007-08-01
Onset:2007-08-02
   Days after vaccination:1
Submitted: 2007-08-28
   Days after onset:26
Entered: 2007-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B129AA / 1 LL / UN
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF117AA / 1 RL / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08690K / 1 LA / UN

Administered by: Private       Purchased by: Unknown
Symptoms: Death, Sudden infant death syndrome
SMQs:, Neonatal disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2007-08-02
   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:
CDC Split Type:

Write-up: 12 hr after receiving the vaccine-baby found dead in hotel bed next to his mother Autopsy Dx: SIDS. 8/31/07 Received vax record from pcp which confirm dose & lot as reported. 1/15/08 Reviewed autopsy report which states COD as Undetermined. Found dead in bed. Findings at autopsy included: SIDS; petechial hemorrhages of thymus & pleura; pulmonary edema & congestion; cerebral edema; & patent ductus arteriosus.


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=289148


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166