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From the 11/19/2021 release of VAERS data:

This is VAERS ID 312543

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Case Details

VAERS ID: 312543 (history)  
Form: Version 1.0  
Age: 0.4  
Sex: Male  
Location: Oklahoma  
Vaccinated:2008-04-25
Onset:2008-04-27
   Days after vaccination:2
Submitted: 2008-05-15
   Days after onset:18
Entered: 2008-05-19
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0067U / 2 UN / UN

Administered by: Public       Purchased by: Unknown
Symptoms: Autopsy, Cyanosis, Respiratory arrest
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Respiratory failure (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2008-04-27
   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: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Awaiting autopsy report performed 4/28/08 also r/o SIDS mother reports
CDC Split Type:

Write-up: 4/27/08 woke up wasn''t breathing- Blue called 911- Sheriff and paramedics. 6/20/08 Autopsy states COD as undetermined. Report states no injuries or disease; all tests neg; history of co-sleeping w/adult. Found supine & unresponsive in bed w/parent w/numerous pillows arranged to keep patient from rolling. CPR initiated.


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