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From the 11/12/2021 release of VAERS data:

This is VAERS ID 415383

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Case Details

VAERS ID: 415383 (history)  
Form: Version 1.0  
Age: 0.18  
Sex: Female  
Location: Florida  
Vaccinated:2010-10-20
Onset:2010-10-21
   Days after vaccination:1
Submitted: 2011-01-25
   Days after onset:96
Entered: 2011-01-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3558AA / 1 LL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH E44433 / 1 RL / IM

Administered by: Unknown       Purchased by: Public
Symptoms: Death, Inappropriate schedule of drug administration
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2010-10-21
   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:
Current Illness:
Preexisting Conditions: PREMI
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: NONE


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