National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts.org
Search Results

From the 1/14/2022 release of VAERS data:

This is VAERS ID 337670

Government Disclaimer on use of this data



Case Details

VAERS ID: 337670 (history)  
Form: Version 1.0  
Age: 0.13  
Sex: Male  
Location: Alabama  
Vaccinated:2009-01-08
Onset:2009-01-10
   Days after vaccination:2
Submitted: 2009-01-12
   Days after onset:2
Entered: 2009-01-16
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B77CA / 1 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF496AA / 1 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH D05882 / 1 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1358X / 1 MO / PO

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2009-01-10
   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: None
Preexisting Conditions: Heart murmur
Allergies:
Diagnostic Lab Data: Autopsy pending
CDC Split Type:

Write-up: Found by father not breathing approximately 0500 on 1/10. Attempted resuscitation at home via police then EMS. To hospital with resuscitation efforts for approximately 1 hr with no results.


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=337670


Copyright © 2022 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166