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This is VAERS ID 422585

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History of Changes from the VAERS Wayback Machine

First Appeared on 5/13/2011

VAERS ID: 422585
VAERS Form:
Age:0.2
Sex:Female
Location:Texas
Vaccinated:2011-05-09
Onset:2011-05-10
Submitted:2011-05-10
Entered:2011-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3882AA / 0 RL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0230AA / 1 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 915371 / 0 LL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0259AA / 0 - / PO

Administered by: Unknown      Purchased by: Private
Symptoms: Death, Epistaxis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-05-10
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: Fluconazole prescribed for thrush.
Current Illness: Thrush
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Autopsy to be performed.
CDC 'Split Type':

Write-up: Pt noted to be lifeless on awaking in morning. Epistaxis reported by father.


Changed on 8/12/2011

VAERS ID: 422585 Before After
VAERS Form:
Age:0.2
Sex:Female
Location:Texas
Vaccinated:2011-05-09
Onset:2011-05-10
Submitted:2011-05-10
Entered:2011-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3882AA / 0 RL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0230AA / 1 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 915371 / 0 LL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0259AA / 0 - / PO

Administered by: Unknown      Purchased by: Private
Symptoms: Death, Epistaxis, Sudden infant death syndrome, Autopsy, Bed sharing

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-05-10
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: Fluconazole prescribed for thrush.
Current Illness: Thrush
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Autopsy to be performed.
CDC 'Split Type':

Write-up: Pt noted to be lifeless on awaking in morning. Epistaxis reported by father.


Changed on 5/13/2013

VAERS ID: 422585 Before After
VAERS Form:
Age:0.2
Sex:Female
Location:Texas
Vaccinated:2011-05-09
Onset:2011-05-10
Submitted:2011-05-10
Entered:2011-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3882AA / 0 RL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0230AA / 1 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 915371 / 0 LL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0259AA / 0 - / PO
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0259AA / 0 - / PO

Administered by: Unknown      Purchased by: Private
Symptoms: Death, Epistaxis, Sudden infant death syndrome, Autopsy, Bed sharing

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-05-10
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: Fluconazole prescribed for thrush.
Current Illness: Thrush
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Autopsy to be performed.
CDC 'Split Type':

Write-up: Pt noted to be lifeless on awaking in morning. Epistaxis reported by father.


Changed on 6/14/2014

VAERS ID: 422585 Before After
VAERS Form:
Age:0.2
Sex:Female
Location:Texas
Vaccinated:2011-05-09
Onset:2011-05-10
Submitted:2011-05-10
Entered:2011-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3882AA / 0 RL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0230AA / 1 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 915371 / 0 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0259AA / 0 - / PO

Administered by: Unknown      Purchased by: Private
Symptoms: Death, Epistaxis, Sudden infant death syndrome, Autopsy, Bed sharing

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-05-10
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: Fluconazole prescribed for thrush.
Current Illness: Thrush
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Autopsy to be performed.
CDC 'Split Type':

Write-up: Pt noted to be lifeless on awaking in morning. Epistaxis reported by father.


Changed on 3/14/2015

VAERS ID: 422585 Before After
VAERS Form:
Age:0.2
Sex:Female
Location:Texas
Vaccinated:2011-05-09
Onset:2011-05-10
Submitted:2011-05-10
Entered:2011-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3882AA / 0 RL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0230AA / 1 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 915371 / 0 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0259AA / 0 - / PO

Administered by: Unknown      Purchased by: Private
Symptoms: Death, Epistaxis, Sudden infant death syndrome, Autopsy, Bed sharing

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-05-10
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: Thrush
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Autopsy to be performed.
CDC 'Split Type':

Write-up: Pt noted to be lifeless on awaking in morning. Epistaxis reported by father.


Changed on 2/14/2017

VAERS ID: 422585 Before After
VAERS Form:
Age:0.2 0.17
Sex:Female
Location:Texas
Vaccinated:2011-05-09
Onset:2011-05-10
Submitted:2011-05-10
Entered:2011-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3882AA / 0 RL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0230AA / 1 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 915371 / 0 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0259AA / 0 - / PO

Administered by: Unknown      Purchased by: Private
Symptoms: Death, Epistaxis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-05-10
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: Thrush
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Autopsy to be performed.
CDC 'Split Type':

Write-up: Pt noted to be lifeless on awaking in morning. Epistaxis reported by father.


Changed on 4/14/2017

VAERS ID: 422585 Before After
VAERS Form:
Age:0.17
Sex:Female
Location:Texas
Vaccinated:2011-05-09
Onset:2011-05-10
Submitted:2011-05-10
Entered:2011-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3882AA / 0 RL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0230AA / 1 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 915371 / 0 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0259AA / 0 - / PO

Administered by: Unknown      Purchased by: Private
Symptoms: Death, Epistaxis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-05-10
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: Fluconazole prescribed for thrush.
Current Illness: Thrush
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Autopsy to be performed.
CDC 'Split Type':

Write-up: Pt noted to be lifeless on awaking in morning. Epistaxis reported by father.


Changed on 9/14/2017

VAERS ID: 422585 Before After
VAERS Form:(blank) 1
Age:0.17
Sex:Female
Location:Texas
Vaccinated:2011-05-09
Onset:2011-05-10
Submitted:2011-05-10
Entered:2011-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3882AA / 0 1 RL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0230AA / 1 2 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 915371 / 0 1 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0259AA / 0 1 - MO / PO

Administered by: Unknown      Purchased by: Private
Symptoms: Death, Epistaxis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-05-10
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: Fluconazole prescribed for thrush.
Current Illness: Thrush
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Autopsy to be performed.
CDC 'Split Type':

Write-up: Pt noted to be lifeless on awaking in morning. Epistaxis reported by father.


Changed on 2/14/2018

VAERS ID: 422585 Before After
VAERS Form:1
Age:0.17
Sex:Female
Location:Texas
Vaccinated:2011-05-09
Onset:2011-05-10
Submitted:2011-05-10
Entered:2011-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3882AA / 1 RL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0230AA / 2 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 915371 / 1 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0259AA / 1 MO / PO

Administered by: Unknown      Purchased by: Private
Symptoms: Death, Epistaxis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-05-10
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: Fluconazole prescribed for thrush.
Current Illness: Thrush
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Autopsy to be performed.
CDC 'Split Type':

Write-up: Pt noted to be lifeless on awaking in morning. Epistaxis reported by father.


Changed on 6/14/2018

VAERS ID: 422585 Before After
VAERS Form:1
Age:0.17
Sex:Female
Location:Texas
Vaccinated:2011-05-09
Onset:2011-05-10
Submitted:2011-05-10
Entered:2011-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3882AA / 1 RL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0230AA / 2 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 915371 / 1 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0259AA / 1 MO / PO

Administered by: Unknown      Purchased by: Private
Symptoms: Death, Epistaxis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-05-10
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: Fluconazole prescribed for thrush.
Current Illness: Thrush
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Autopsy to be performed.
CDC 'Split Type':

Write-up: Pt noted to be lifeless on awaking in morning. Epistaxis reported by father.


Changed on 8/14/2018

VAERS ID: 422585 Before After
VAERS Form:1
Age:0.17
Sex:Female
Location:Texas
Vaccinated:2011-05-09
Onset:2011-05-10
Submitted:2011-05-10
Entered:2011-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3882AA / 1 RL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0230AA / 2 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 915371 / 1 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0259AA / 1 MO / PO

Administered by: Unknown      Purchased by: Private
Symptoms: Death, Epistaxis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-05-10
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: Fluconazole prescribed for thrush.
Current Illness: Thrush
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Autopsy to be performed.
CDC 'Split Type':

Write-up: Pt noted to be lifeless on awaking in morning. Epistaxis reported by father.


Changed on 9/14/2018

VAERS ID: 422585 Before After
VAERS Form:1
Age:0.17
Sex:Female
Location:Texas
Vaccinated:2011-05-09
Onset:2011-05-10
Submitted:2011-05-10
Entered:2011-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3882AA / 1 RL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0230AA / 2 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 915371 / 1 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0259AA / 1 MO / PO

Administered by: Unknown      Purchased by: Private
Symptoms: Death, Epistaxis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-05-10
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: Fluconazole prescribed for thrush.
Current Illness: Thrush
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Autopsy to be performed.
CDC 'Split Type':

Write-up: Pt noted to be lifeless on awaking in morning. Epistaxis reported by father.


Changed on 10/14/2018

VAERS ID: 422585 Before After
VAERS Form:1
Age:0.17
Sex:Female
Location:Texas
Vaccinated:2011-05-09
Onset:2011-05-10
Submitted:2011-05-10
Entered:2011-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3882AA / 1 RL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0230AA / 2 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 915371 / 1 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0259AA / 1 MO / PO

Administered by: Unknown      Purchased by: Private
Symptoms: Death, Epistaxis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-05-10
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: Fluconazole prescribed for thrush.
Current Illness: Thrush
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Autopsy to be performed.
CDC 'Split Type':

Write-up: Pt noted to be lifeless on awaking in morning. Epistaxis reported by father.


Changed on 12/24/2020

VAERS ID: 422585 Before After
VAERS Form:1
Age:0.17
Sex:Female
Location:Texas
Vaccinated:2011-05-09
Onset:2011-05-10
Submitted:2011-05-10
Entered:2011-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3882AA / 1 RL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0230AA / 2 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 915371 / 1 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0259AA / 1 MO / PO

Administered by: Unknown      Purchased by: Private
Symptoms: Death, Epistaxis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-05-10
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: Fluconazole prescribed for thrush.
Current Illness: Thrush
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Autopsy to be performed.
CDC 'Split Type':

Write-up: Pt noted to be lifeless on awaking in morning. Epistaxis reported by father.


Changed on 12/30/2020

VAERS ID: 422585 Before After
VAERS Form:1
Age:0.17
Sex:Female
Location:Texas
Vaccinated:2011-05-09
Onset:2011-05-10
Submitted:2011-05-10
Entered:2011-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3882AA / 1 RL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0230AA / 2 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 915371 / 1 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0259AA / 1 MO / PO

Administered by: Unknown      Purchased by: Private
Symptoms: Death, Epistaxis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-05-10
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: Fluconazole prescribed for thrush.
Current Illness: Thrush
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Autopsy to be performed.
CDC 'Split Type':

Write-up: Pt noted to be lifeless on awaking in morning. Epistaxis reported by father.


Changed on 5/7/2021

VAERS ID: 422585 Before After
VAERS Form:1
Age:0.17
Sex:Female
Location:Texas
Vaccinated:2011-05-09
Onset:2011-05-10
Submitted:2011-05-10
Entered:2011-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3882AA / 1 RL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0230AA / 2 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 915371 / 1 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0259AA / 1 MO / PO

Administered by: Unknown      Purchased by: Private
Symptoms: Death, Epistaxis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-05-10
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: Fluconazole prescribed for thrush.
Current Illness: Thrush
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Autopsy to be performed.
CDC 'Split Type':

Write-up: Pt noted to be lifeless on awaking in morning. Epistaxis reported by father.


Changed on 5/14/2021

VAERS ID: 422585 Before After
VAERS Form:1
Age:0.17
Sex:Female
Location:Texas
Vaccinated:2011-05-09
Onset:2011-05-10
Submitted:2011-05-10
Entered:2011-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3882AA / 1 RL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0230AA / 2 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 915371 / 1 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0259AA / 1 MO / PO

Administered by: Unknown      Purchased by: Private
Symptoms: Death, Epistaxis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-05-10
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: Fluconazole prescribed for thrush.
Current Illness: Thrush
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Autopsy to be performed.
CDC 'Split Type':

Write-up: Pt noted to be lifeless on awaking in morning. Epistaxis reported by father.

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