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From the 1/7/2022 release of VAERS data:

This is VAERS ID 338667

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Case Details

VAERS ID: 338667 (history)  
Form: Version 1.0  
Age: 1.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2009-01-27
Onset:2009-01-28
   Days after vaccination:1
Submitted: 2009-01-28
   Days after onset:0
Entered: 2009-01-30
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U2810AA / 2 RL / UN
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB274AD / 1 RL / UN
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1369X / 1 LL / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH 021052 / 4 RL / UN
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1406X / 1 LL / UN

Administered by: Private       Purchased by: Private
Symptoms: Autopsy
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2009-01-28
   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: Autopsy is being performed
CDC Split Type:

Write-up: Sudden death at home morning of 1/28/09. 6/1/09 Autopsy report states COD as sudden unexpected infant death & manner of death as natural. Report also states patient found dead in crib, tox screens & cultures all neg.


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