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This is VAERS ID 379004

History of Changes from the VAERS Wayback Machine

First Appeared on 2/5/2010

VAERS ID: 379004
VAERS Form:
Age:0.1
Sex:Male
Location:Oklahoma
Vaccinated:2010-01-20
Onset:2010-01-21
Submitted:2010-02-01
Entered:2010-02-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVB762BA / 1 RL / IM

Administered by: Public      Purchased by: Public
Symptoms: Asphyxia, Death, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-01-21
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: well child check 1-20-2010. Infant received Hepatitis B vaccine on 1-20-2010. Aunt found infant ,on the morning of 1-21-2010, dead in the bed with mother,who was asleep. suspect SIDS or accidental suffocation.


Changed on 4/13/2011

VAERS ID: 379004 Before After
VAERS Form:
Age:0.1
Sex:Male
Location:Oklahoma
Vaccinated:2010-01-20
Onset:2010-01-21
Submitted:2010-02-01
Entered:2010-02-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVB762BA / 1 RL / IM

Administered by: Public      Purchased by: Public
Symptoms: Asphyxia, Breast feeding, Cardiac arrest, Cardio-respiratory arrest, Death, Loss of consciousness, Pulse absent, Resuscitation, Skeletal survey normal, Sudden infant death syndrome, Toxicologic test normal, Endotracheal intubation

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-01-21
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: well child check 1-20-2010. Infant received Hepatitis B vaccine on 1-20-2010. Aunt found infant ,on the morning of 1-21-2010, dead in the bed with mother,who was asleep. suspect SIDS or accidental suffocation.


Changed on 5/13/2011

VAERS ID: 379004 Before After
VAERS Form:
Age:0.1
Sex:Male
Location:Oklahoma
Vaccinated:2010-01-20
Onset:2010-01-21
Submitted:2010-02-01
Entered:2010-02-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVB762BA / 1 RL / IM

Administered by: Public      Purchased by: Public
Symptoms: Asphyxia, Breast feeding, Cardiac arrest, Cardio-respiratory arrest, Death, Loss of consciousness, Pulse absent, Resuscitation, Skeletal survey normal, Sudden infant death syndrome, Toxicologic test normal, Endotracheal intubation

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-01-21
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: well child check 1-20-2010. Infant received Hepatitis B vaccine on 1-20-2010. Aunt found infant ,on the morning of 1-21-2010, dead in the bed with mother,who was asleep. suspect SIDS or accidental suffocation.


Changed on 6/11/2011

VAERS ID: 379004 Before After
VAERS Form:
Age:0.1
Sex:Male
Location:Oklahoma
Vaccinated:2010-01-20
Onset:2010-01-21
Submitted:2010-02-01
Entered:2010-02-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVB762BA / 1 RL / IM

Administered by: Public      Purchased by: Public
Symptoms: Asphyxia, Breast feeding, Cardiac arrest, Cardio-respiratory arrest, Death, Loss of consciousness, Pulse absent, Resuscitation, Skeletal survey normal, Sudden infant death syndrome, Toxicologic test normal, Endotracheal intubation

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-01-21
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: well child check 1-20-2010. Infant received Hepatitis B vaccine on 1-20-2010. Aunt found infant ,on the morning of 1-21-2010, dead in the bed with mother,who was asleep. suspect SIDS or accidental suffocation.


Changed on 6/14/2014

VAERS ID: 379004 Before After
VAERS Form:
Age:0.1
Sex:Male
Location:Oklahoma
Vaccinated:2010-01-20
Onset:2010-01-21
Submitted:2010-02-01
Entered:2010-02-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVB762BA / 1 RL / IM

Administered by: Public      Purchased by: Public
Symptoms: Asphyxia, Breast feeding, Cardiac arrest, Cardio-respiratory arrest, Death, Loss of consciousness, Pulse absent, Resuscitation, Skeletal survey normal, Sudden infant death syndrome, Toxicologic test normal, Endotracheal intubation

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-01-21
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: well child check 1-20-2010. Infant received Hepatitis B vaccine on 1-20-2010. Aunt found infant ,on the morning of 1-21-2010, dead in the bed with mother,who was asleep. suspect SIDS or accidental suffocation.


Changed on 3/14/2015

VAERS ID: 379004 Before After
VAERS Form:
Age:0.1
Sex:Male
Location:Oklahoma
Vaccinated:2010-01-20
Onset:2010-01-21
Submitted:2010-02-01
Entered:2010-02-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVB762BA / 1 RL / IM

Administered by: Public      Purchased by: Public
Symptoms: Asphyxia, Breast feeding, Cardiac arrest, Cardio-respiratory arrest, Death, Loss of consciousness, Pulse absent, Resuscitation, Skeletal survey normal, Sudden infant death syndrome, Toxicologic test normal, Endotracheal intubation

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-01-21
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: well child check 1-20-2010. Infant received Hepatitis B vaccine on 1-20-2010. Aunt found infant ,on the morning of 1-21-2010, dead in the bed with mother,who was asleep. suspect SIDS or accidental suffocation.


Changed on 2/14/2017

VAERS ID: 379004 Before After
VAERS Form:
Age:0.1 0.11
Sex:Male
Location:Oklahoma
Vaccinated:2010-01-20
Onset:2010-01-21
Submitted:2010-02-01
Entered:2010-02-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVB762BA / 1 RL / IM

Administered by: Public      Purchased by: Public
Symptoms: Asphyxia, Death, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-01-21
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: well child check 1-20-2010. Infant received Hepatitis B vaccine on 1-20-2010. Aunt found infant ,on the morning of 1-21-2010, dead in the bed with mother,who was asleep. suspect SIDS or accidental suffocation.


Changed on 4/14/2017

VAERS ID: 379004 Before After
VAERS Form:
Age:0.11
Sex:Male
Location:Oklahoma
Vaccinated:2010-01-20
Onset:2010-01-21
Submitted:2010-02-01
Entered:2010-02-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVB762BA / 1 RL / IM

Administered by: Public      Purchased by: Public
Symptoms: Asphyxia, Death, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-01-21
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: well child check 1-20-2010. Infant received Hepatitis B vaccine on 1-20-2010. Aunt found infant ,on the morning of 1-21-2010, dead in the bed with mother,who was asleep. suspect SIDS or accidental suffocation.


Changed on 9/14/2017

VAERS ID: 379004 Before After
VAERS Form:(blank) 1
Age:0.11
Sex:Male
Location:Oklahoma
Vaccinated:2010-01-20
Onset:2010-01-21
Submitted:2010-02-01
Entered:2010-02-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVB762BA / 1 2 RL / IM

Administered by: Public      Purchased by: Public
Symptoms: Asphyxia, Death, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-01-21
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: well child check 1-20-2010. Infant received Hepatitis B vaccine on 1-20-2010. Aunt found infant ,on the morning of 1-21-2010, dead in the bed with mother,who was asleep. suspect SIDS or accidental suffocation.


Changed on 2/14/2018

VAERS ID: 379004 Before After
VAERS Form:1
Age:0.11
Sex:Male
Location:Oklahoma
Vaccinated:2010-01-20
Onset:2010-01-21
Submitted:2010-02-01
Entered:2010-02-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVB762BA / 2 RL / IM

Administered by: Public      Purchased by: Public
Symptoms: Asphyxia, Death, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-01-21
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: well child check 1-20-2010. Infant received Hepatitis B vaccine on 1-20-2010. Aunt found infant ,on the morning of 1-21-2010, dead in the bed with mother,who was asleep. suspect SIDS or accidental suffocation.


Changed on 6/14/2018

VAERS ID: 379004 Before After
VAERS Form:1
Age:0.11
Sex:Male
Location:Oklahoma
Vaccinated:2010-01-20
Onset:2010-01-21
Submitted:2010-02-01
Entered:2010-02-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVB762BA / 2 RL / IM

Administered by: Public      Purchased by: Public
Symptoms: Asphyxia, Death, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-01-21
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: well child check 1-20-2010. Infant received Hepatitis B vaccine on 1-20-2010. Aunt found infant ,on the morning of 1-21-2010, dead in the bed with mother,who was asleep. suspect SIDS or accidental suffocation.


Changed on 8/14/2018

VAERS ID: 379004 Before After
VAERS Form:1
Age:0.11
Sex:Male
Location:Oklahoma
Vaccinated:2010-01-20
Onset:2010-01-21
Submitted:2010-02-01
Entered:2010-02-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVB762BA / 2 RL / IM

Administered by: Public      Purchased by: Public
Symptoms: Asphyxia, Death, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-01-21
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: well child check 1-20-2010. Infant received Hepatitis B vaccine on 1-20-2010. Aunt found infant ,on the morning of 1-21-2010, dead in the bed with mother,who was asleep. suspect SIDS or accidental suffocation.


Changed on 9/14/2018

VAERS ID: 379004 Before After
VAERS Form:1
Age:0.11
Sex:Male
Location:Oklahoma
Vaccinated:2010-01-20
Onset:2010-01-21
Submitted:2010-02-01
Entered:2010-02-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVB762BA / 2 RL / IM

Administered by: Public      Purchased by: Public
Symptoms: Asphyxia, Death, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-01-21
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: well child check 1-20-2010. Infant received Hepatitis B vaccine on 1-20-2010. Aunt found infant ,on the morning of 1-21-2010, dead in the bed with mother,who was asleep. suspect SIDS or accidental suffocation.


Changed on 10/14/2018

VAERS ID: 379004 Before After
VAERS Form:1
Age:0.11
Sex:Male
Location:Oklahoma
Vaccinated:2010-01-20
Onset:2010-01-21
Submitted:2010-02-01
Entered:2010-02-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVB762BA / 2 RL / IM

Administered by: Public      Purchased by: Public
Symptoms: Asphyxia, Death, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-01-21
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: well child check 1-20-2010. Infant received Hepatitis B vaccine on 1-20-2010. Aunt found infant ,on the morning of 1-21-2010, dead in the bed with mother,who was asleep. suspect SIDS or accidental suffocation.


Changed on 12/24/2020

VAERS ID: 379004 Before After
VAERS Form:1
Age:0.11
Sex:Male
Location:Oklahoma
Vaccinated:2010-01-20
Onset:2010-01-21
Submitted:2010-02-01
Entered:2010-02-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVB762BA / 2 RL / IM

Administered by: Public      Purchased by: Public
Symptoms: Asphyxia, Death, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-01-21
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: well child check 1-20-2010. Infant received Hepatitis B vaccine on 1-20-2010. Aunt found infant ,on the morning of 1-21-2010, dead in the bed with mother,who was asleep. suspect SIDS or accidental suffocation.


Changed on 12/30/2020

VAERS ID: 379004 Before After
VAERS Form:1
Age:0.11
Sex:Male
Location:Oklahoma
Vaccinated:2010-01-20
Onset:2010-01-21
Submitted:2010-02-01
Entered:2010-02-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVB762BA / 2 RL / IM

Administered by: Public      Purchased by: Public
Symptoms: Asphyxia, Death, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-01-21
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: well child check 1-20-2010. Infant received Hepatitis B vaccine on 1-20-2010. Aunt found infant ,on the morning of 1-21-2010, dead in the bed with mother,who was asleep. suspect SIDS or accidental suffocation.


Changed on 5/7/2021

VAERS ID: 379004 Before After
VAERS Form:1
Age:0.11
Sex:Male
Location:Oklahoma
Vaccinated:2010-01-20
Onset:2010-01-21
Submitted:2010-02-01
Entered:2010-02-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVB762BA / 2 RL / IM

Administered by: Public      Purchased by: Public
Symptoms: Asphyxia, Death, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-01-21
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: well child check 1-20-2010. Infant received Hepatitis B vaccine on 1-20-2010. Aunt found infant ,on the morning of 1-21-2010, dead in the bed with mother,who was asleep. suspect SIDS or accidental suffocation.


Changed on 5/14/2021

VAERS ID: 379004 Before After
VAERS Form:1
Age:0.11
Sex:Male
Location:Oklahoma
Vaccinated:2010-01-20
Onset:2010-01-21
Submitted:2010-02-01
Entered:2010-02-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVB762BA / 2 RL / IM

Administered by: Public      Purchased by: Public
Symptoms: Asphyxia, Death, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-01-21
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: well child check 1-20-2010. Infant received Hepatitis B vaccine on 1-20-2010. Aunt found infant ,on the morning of 1-21-2010, dead in the bed with mother,who was asleep. suspect SIDS or accidental suffocation.

New Search

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=379004&WAYBACKHISTORY=ON


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