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This is VAERS ID 414023

History of Changes from the VAERS Wayback Machine

First Appeared on 1/4/2011

VAERS ID: 414023
VAERS Form:
Age:0.3
Sex:Unknown
Location:New Hampshire
Vaccinated:2010-10-08
Onset:2010-10-27
Submitted:2011-01-04
Entered:2011-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB807CA / 1 RL / UN
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3670AA / 1 RL / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH E57643 / 1 RL / UN
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. D07962 / 1 - / PO

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-10-27
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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NH01042011

Write-up: Pt got birth dose of Hep B 7/31/10 SIDS baby.


Changed on 4/13/2011

VAERS ID: 414023 Before After
VAERS Form:
Age:0.3
Sex:Unknown
Location:New Hampshire
Vaccinated:2010-10-08
Onset:2010-10-27
Submitted:2011-01-04
Entered:2011-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB807CA / 1 RL / UN
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3670AA / 1 RL / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH E57643 / 1 RL / UN
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. D07962 / 1 - / PO

Administered by: Private      Purchased by: Public
Symptoms: Death, Gliosis, Nasopharyngitis, Sudden infant death syndrome, Unresponsive to stimuli

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-10-27
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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NH01042011

Write-up: Pt got birth dose of Hep B 7/31/10 SIDS baby.


Changed on 5/13/2011

VAERS ID: 414023 Before After
VAERS Form:
Age:0.3
Sex:Unknown
Location:New Hampshire
Vaccinated:2010-10-08
Onset:2010-10-27
Submitted:2011-01-04
Entered:2011-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB807CA / 1 RL / UN
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3670AA / 1 RL / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH E57643 / 1 RL / UN
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. D07962 / 1 - / PO

Administered by: Private      Purchased by: Public
Symptoms: Death, Gliosis, Nasopharyngitis, Sudden infant death syndrome, Unresponsive to stimuli

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-10-27
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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NH01042011

Write-up: Pt got birth dose of Hep B 7/31/10 SIDS baby.


Changed on 5/13/2013

VAERS ID: 414023 Before After
VAERS Form:
Age:0.3
Sex:Unknown
Location:New Hampshire
Vaccinated:2010-10-08
Onset:2010-10-27
Submitted:2011-01-04
Entered:2011-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB807CA / 1 RL / UN
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3670AA / 1 RL / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH E57643 / 1 RL / UN
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. D07962 / 1 - / PO
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. D07962 / 1 - / PO

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-10-27
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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NH01042011

Write-up: Pt got birth dose of Hep B 7/31/10 SIDS baby.


Changed on 2/14/2017

VAERS ID: 414023 Before After
VAERS Form:
Age:0.3 0.27
Sex:Unknown
Location:New Hampshire
Vaccinated:2010-10-08
Onset:2010-10-27
Submitted:2011-01-04
Entered:2011-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB807CA / 1 RL / UN
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3670AA / 1 RL / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH E57643 / 1 RL / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. D07962 / 1 - / PO

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-10-27
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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NH01042011

Write-up: Pt got birth dose of Hep B 7/31/10 SIDS baby.


Changed on 9/14/2017

VAERS ID: 414023 Before After
VAERS Form:(blank) 1
Age:0.27
Sex:Unknown
Location:New Hampshire
Vaccinated:2010-10-08
Onset:2010-10-27
Submitted:2011-01-04
Entered:2011-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB807CA / 1 2 RL / UN
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3670AA / 1 2 RL / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH E57643 / 1 2 RL / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. D07962 / 1 2 - MO / PO

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-10-27
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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NH01042011

Write-up: Pt got birth dose of Hep B 7/31/10 SIDS baby.


Changed on 2/14/2018

VAERS ID: 414023 Before After
VAERS Form:1
Age:0.27
Sex:Unknown
Location:New Hampshire
Vaccinated:2010-10-08
Onset:2010-10-27
Submitted:2011-01-04
Entered:2011-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB807CA / 2 RL / UN
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3670AA / 2 RL / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH E57643 / 2 RL / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. D07962 / 2 MO / PO

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-10-27
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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NH01042011

Write-up: Pt got birth dose of Hep B 7/31/10 SIDS baby.


Changed on 6/14/2018

VAERS ID: 414023 Before After
VAERS Form:1
Age:0.27
Sex:Unknown
Location:New Hampshire
Vaccinated:2010-10-08
Onset:2010-10-27
Submitted:2011-01-04
Entered:2011-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB807CA / 2 RL / UN
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3670AA / 2 RL / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH E57643 / 2 RL / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. D07962 / 2 MO / PO

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-10-27
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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NH01042011

Write-up: Pt got birth dose of Hep B 7/31/10 SIDS baby.


Changed on 8/14/2018

VAERS ID: 414023 Before After
VAERS Form:1
Age:0.27
Sex:Unknown
Location:New Hampshire
Vaccinated:2010-10-08
Onset:2010-10-27
Submitted:2011-01-04
Entered:2011-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB807CA / 2 RL / UN
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3670AA / 2 RL / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH E57643 / 2 RL / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. D07962 / 2 MO / PO

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-10-27
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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NH01042011

Write-up: Pt got birth dose of Hep B 7/31/10 SIDS baby.


Changed on 9/14/2018

VAERS ID: 414023 Before After
VAERS Form:1
Age:0.27
Sex:Unknown
Location:New Hampshire
Vaccinated:2010-10-08
Onset:2010-10-27
Submitted:2011-01-04
Entered:2011-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB807CA / 2 RL / UN
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3670AA / 2 RL / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH E57643 / 2 RL / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. D07962 / 2 MO / PO

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-10-27
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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NH01042011

Write-up: Pt got birth dose of Hep B 7/31/10 SIDS baby.


Changed on 10/14/2018

VAERS ID: 414023 Before After
VAERS Form:1
Age:0.27
Sex:Unknown
Location:New Hampshire
Vaccinated:2010-10-08
Onset:2010-10-27
Submitted:2011-01-04
Entered:2011-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB807CA / 2 RL / UN
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3670AA / 2 RL / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH E57643 / 2 RL / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. D07962 / 2 MO / PO

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-10-27
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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NH01042011

Write-up: Pt got birth dose of Hep B 7/31/10 SIDS baby.


Changed on 12/24/2020

VAERS ID: 414023 Before After
VAERS Form:1
Age:0.27
Sex:Unknown
Location:New Hampshire
Vaccinated:2010-10-08
Onset:2010-10-27
Submitted:2011-01-04
Entered:2011-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB807CA / 2 RL / UN
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3670AA / 2 RL / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH E57643 / 2 RL / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. D07962 / 2 MO / PO

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-10-27
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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NH01042011

Write-up: Pt got birth dose of Hep B 7/31/10 SIDS baby.


Changed on 12/30/2020

VAERS ID: 414023 Before After
VAERS Form:1
Age:0.27
Sex:Unknown
Location:New Hampshire
Vaccinated:2010-10-08
Onset:2010-10-27
Submitted:2011-01-04
Entered:2011-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB807CA / 2 RL / UN
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3670AA / 2 RL / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH E57643 / 2 RL / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. D07962 / 2 MO / PO

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-10-27
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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NH01042011

Write-up: Pt got birth dose of Hep B 7/31/10 SIDS baby.


Changed on 5/7/2021

VAERS ID: 414023 Before After
VAERS Form:1
Age:0.27
Sex:Unknown
Location:New Hampshire
Vaccinated:2010-10-08
Onset:2010-10-27
Submitted:2011-01-04
Entered:2011-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB807CA / 2 RL / UN
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3670AA / 2 RL / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH E57643 / 2 RL / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. D07962 / 2 MO / PO

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-10-27
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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NH01042011

Write-up: Pt got birth dose of Hep B 7/31/10 SIDS baby.


Changed on 5/14/2021

VAERS ID: 414023 Before After
VAERS Form:1
Age:0.27
Sex:Unknown
Location:New Hampshire
Vaccinated:2010-10-08
Onset:2010-10-27
Submitted:2011-01-04
Entered:2011-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB807CA / 2 RL / UN
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3670AA / 2 RL / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH E57643 / 2 RL / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. D07962 / 2 MO / PO

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-10-27
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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NH01042011

Write-up: Pt got birth dose of Hep B 7/31/10 SIDS baby.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=414023&WAYBACKHISTORY=ON

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