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This is VAERS ID 422773

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History of Changes from the VAERS Wayback Machine

First Appeared on 5/13/2011

VAERS ID: 422773
VAERS Form:
Age:0.4
Sex:Female
Location:Alabama
Vaccinated:2011-04-27
Onset:2011-05-03
Submitted:2011-05-12
Entered:2011-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3800 / 1 UN / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 914972 / 1 UN / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1653Z / 0 - / PO

Administered by: Private      Purchased by: Public
Symptoms: Respiratory arrest, Sudden infant death syndrome, Unresponsive to stimuli

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-05-03
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: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: SIDS. Was found not breathing and unresponsive in crib after nap.


Record is removed as of 2/13/2013


Changed on 5/13/2013

VAERS ID: 422773 Before After
VAERS Form:
Age:0.4
Sex:Female
Location:Alabama
Vaccinated:2011-04-27
Onset:2011-05-03
Submitted:2011-05-12
Entered:2011-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3800 / 1 UN / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 914972 / 1 UN / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1653Z / 0 - / PO
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1653Z / 0 - / PO

Administered by: Private      Purchased by: Public
Symptoms: Respiratory arrest, Sudden infant death syndrome, Unresponsive to stimuli

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-05-03
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: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: SIDS. Was found not breathing and unresponsive in crib after nap.


Changed on 2/14/2017

VAERS ID: 422773 Before After
VAERS Form:
Age:0.4 0.37
Sex:Female
Location:Alabama
Vaccinated:2011-04-27
Onset:2011-05-03
Submitted:2011-05-12
Entered:2011-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3800 / 1 UN / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 914972 / 1 UN / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1653Z / 0 - / PO

Administered by: Private      Purchased by: Public
Symptoms: Respiratory arrest, Sudden infant death syndrome, Unresponsive to stimuli

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-05-03
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: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: SIDS. Was found not breathing and unresponsive in crib after nap.


Changed on 9/14/2017

VAERS ID: 422773 Before After
VAERS Form:(blank) 1
Age:0.37
Sex:Female
Location:Alabama
Vaccinated:2011-04-27
Onset:2011-05-03
Submitted:2011-05-12
Entered:2011-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3800 / 1 2 UN / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 914972 / 1 2 UN / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1653Z / 0 1 - MO / PO

Administered by: Private      Purchased by: Public
Symptoms: Respiratory arrest, Sudden infant death syndrome, Unresponsive to stimuli

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-05-03
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: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: SIDS. Was found not breathing and unresponsive in crib after nap.


Changed on 2/14/2018

VAERS ID: 422773 Before After
VAERS Form:1
Age:0.37
Sex:Female
Location:Alabama
Vaccinated:2011-04-27
Onset:2011-05-03
Submitted:2011-05-12
Entered:2011-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3800 / 2 UN / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 914972 / 2 UN / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1653Z / 1 MO / PO

Administered by: Private      Purchased by: Public
Symptoms: Respiratory arrest, Sudden infant death syndrome, Unresponsive to stimuli

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-05-03
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: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: SIDS. Was found not breathing and unresponsive in crib after nap.


Changed on 6/14/2018

VAERS ID: 422773 Before After
VAERS Form:1
Age:0.37
Sex:Female
Location:Alabama
Vaccinated:2011-04-27
Onset:2011-05-03
Submitted:2011-05-12
Entered:2011-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3800 / 2 UN / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 914972 / 2 UN / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1653Z / 1 MO / PO

Administered by: Private      Purchased by: Public
Symptoms: Respiratory arrest, Sudden infant death syndrome, Unresponsive to stimuli

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-05-03
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: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: SIDS. Was found not breathing and unresponsive in crib after nap.


Changed on 8/14/2018

VAERS ID: 422773 Before After
VAERS Form:1
Age:0.37
Sex:Female
Location:Alabama
Vaccinated:2011-04-27
Onset:2011-05-03
Submitted:2011-05-12
Entered:2011-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3800 / 2 UN / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 914972 / 2 UN / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1653Z / 1 MO / PO

Administered by: Private      Purchased by: Public
Symptoms: Respiratory arrest, Sudden infant death syndrome, Unresponsive to stimuli

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-05-03
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: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: SIDS. Was found not breathing and unresponsive in crib after nap.


Changed on 9/14/2018

VAERS ID: 422773 Before After
VAERS Form:1
Age:0.37
Sex:Female
Location:Alabama
Vaccinated:2011-04-27
Onset:2011-05-03
Submitted:2011-05-12
Entered:2011-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3800 / 2 UN / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 914972 / 2 UN / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1653Z / 1 MO / PO

Administered by: Private      Purchased by: Public
Symptoms: Respiratory arrest, Sudden infant death syndrome, Unresponsive to stimuli

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-05-03
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: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: SIDS. Was found not breathing and unresponsive in crib after nap.


Changed on 10/14/2018

VAERS ID: 422773 Before After
VAERS Form:1
Age:0.37
Sex:Female
Location:Alabama
Vaccinated:2011-04-27
Onset:2011-05-03
Submitted:2011-05-12
Entered:2011-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3800 / 2 UN / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 914972 / 2 UN / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1653Z / 1 MO / PO

Administered by: Private      Purchased by: Public
Symptoms: Respiratory arrest, Sudden infant death syndrome, Unresponsive to stimuli

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-05-03
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: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: SIDS. Was found not breathing and unresponsive in crib after nap.


Changed on 12/24/2020

VAERS ID: 422773 Before After
VAERS Form:1
Age:0.37
Sex:Female
Location:Alabama
Vaccinated:2011-04-27
Onset:2011-05-03
Submitted:2011-05-12
Entered:2011-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3800 / 2 UN / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 914972 / 2 UN / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1653Z / 1 MO / PO

Administered by: Private      Purchased by: Public
Symptoms: Respiratory arrest, Sudden infant death syndrome, Unresponsive to stimuli

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-05-03
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: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: SIDS. Was found not breathing and unresponsive in crib after nap.


Changed on 12/30/2020

VAERS ID: 422773 Before After
VAERS Form:1
Age:0.37
Sex:Female
Location:Alabama
Vaccinated:2011-04-27
Onset:2011-05-03
Submitted:2011-05-12
Entered:2011-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3800 / 2 UN / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 914972 / 2 UN / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1653Z / 1 MO / PO

Administered by: Private      Purchased by: Public
Symptoms: Respiratory arrest, Sudden infant death syndrome, Unresponsive to stimuli

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-05-03
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: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: SIDS. Was found not breathing and unresponsive in crib after nap.


Changed on 5/7/2021

VAERS ID: 422773 Before After
VAERS Form:1
Age:0.37
Sex:Female
Location:Alabama
Vaccinated:2011-04-27
Onset:2011-05-03
Submitted:2011-05-12
Entered:2011-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3800 / 2 UN / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 914972 / 2 UN / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1653Z / 1 MO / PO

Administered by: Private      Purchased by: Public
Symptoms: Respiratory arrest, Sudden infant death syndrome, Unresponsive to stimuli

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-05-03
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: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: SIDS. Was found not breathing and unresponsive in crib after nap.


Changed on 5/14/2021

VAERS ID: 422773 Before After
VAERS Form:1
Age:0.37
Sex:Female
Location:Alabama
Vaccinated:2011-04-27
Onset:2011-05-03
Submitted:2011-05-12
Entered:2011-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3800 / 2 UN / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 914972 / 2 UN / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1653Z / 1 MO / PO

Administered by: Private      Purchased by: Public
Symptoms: Respiratory arrest, Sudden infant death syndrome, Unresponsive to stimuli

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-05-03
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: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: SIDS. Was found not breathing and unresponsive in crib after nap.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=422773&WAYBACKHISTORY=ON


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