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This is VAERS ID 424300

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History of Changes from the VAERS Wayback Machine

First Appeared on 6/11/2011

VAERS ID: 424300
VAERS Form:
Age:0.3
Sex:Male
Location:Kentucky
Vaccinated:2011-05-18
Onset:0000-00-00
Submitted:2011-05-25
Entered:2011-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (NO BRAND NAME) / SANOFI PASTEUR C3548AA / 1 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 915706 / 1 LL / IM

Administered by: Public      Purchased by: Public
Symptoms: Asphyxia, Death, Unresponsive to stimuli, Autopsy

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-05-20
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: Born addicted to drugs. Weaned off morphine & phenobarbital.
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: No known vaccine adverse reactions; parents report father rolled over on infant found unresponsive per mother; preliminary autopsy: asphyxiation per suffocation.


Changed on 2/14/2017

VAERS ID: 424300 Before After
VAERS Form:
Age:0.3 0.34
Sex:Male
Location:Kentucky
Vaccinated:2011-05-18
Onset:0000-00-00
Submitted:2011-05-25
Entered:2011-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (NO BRAND NAME) / SANOFI PASTEUR C3548AA / 1 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 915706 / 1 LL / IM

Administered by: Public      Purchased by: Public
Symptoms: Asphyxia, Death, Unresponsive to stimuli, Autopsy

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-05-20
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: Born addicted to drugs. Weaned off morphine & phenobarbital.
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: No known vaccine adverse reactions; parents report father rolled over on infant found unresponsive per mother; preliminary autopsy: asphyxiation per suffocation.


Changed on 9/14/2017

VAERS ID: 424300 Before After
VAERS Form:(blank) 1
Age:0.34
Sex:Male
Location:Kentucky
Vaccinated:2011-05-18
Onset:0000-00-00
Submitted:2011-05-25
Entered:2011-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (NO BRAND NAME) / SANOFI PASTEUR C3548AA / 1 2 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 915706 / 1 2 LL / IM

Administered by: Public      Purchased by: Public
Symptoms: Asphyxia, Death, Unresponsive to stimuli, Autopsy

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-05-20
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: Born addicted to drugs. Weaned off morphine & phenobarbital.
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: No known vaccine adverse reactions; parents report father rolled over on infant found unresponsive per mother; preliminary autopsy: asphyxiation per suffocation.


Changed on 2/14/2018

VAERS ID: 424300 Before After
VAERS Form:1
Age:0.34
Sex:Male
Location:Kentucky
Vaccinated:2011-05-18
Onset:0000-00-00
Submitted:2011-05-25
Entered:2011-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (NO BRAND NAME) / SANOFI PASTEUR C3548AA / 2 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 915706 / 2 LL / IM

Administered by: Public      Purchased by: Public
Symptoms: Asphyxia, Death, Unresponsive to stimuli, Autopsy

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-05-20
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: Born addicted to drugs. Weaned off morphine & phenobarbital.
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: No known vaccine adverse reactions; parents report father rolled over on infant found unresponsive per mother; preliminary autopsy: asphyxiation per suffocation.


Changed on 6/14/2018

VAERS ID: 424300 Before After
VAERS Form:1
Age:0.34
Sex:Male
Location:Kentucky
Vaccinated:2011-05-18
Onset:0000-00-00
Submitted:2011-05-25
Entered:2011-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (NO BRAND NAME) / SANOFI PASTEUR C3548AA / 2 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 915706 / 2 LL / IM

Administered by: Public      Purchased by: Public
Symptoms: Asphyxia, Death, Unresponsive to stimuli, Autopsy

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-05-20
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: Born addicted to drugs. Weaned off morphine & phenobarbital.
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: No known vaccine adverse reactions; parents report father rolled over on infant found unresponsive per mother; preliminary autopsy: asphyxiation per suffocation.


Changed on 8/14/2018

VAERS ID: 424300 Before After
VAERS Form:1
Age:0.34
Sex:Male
Location:Kentucky
Vaccinated:2011-05-18
Onset:0000-00-00
Submitted:2011-05-25
Entered:2011-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (NO BRAND NAME) / SANOFI PASTEUR C3548AA / 2 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 915706 / 2 LL / IM

Administered by: Public      Purchased by: Public
Symptoms: Asphyxia, Death, Unresponsive to stimuli, Autopsy

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-05-20
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: Born addicted to drugs. Weaned off morphine & phenobarbital.
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: No known vaccine adverse reactions; parents report father rolled over on infant found unresponsive per mother; preliminary autopsy: asphyxiation per suffocation.


Changed on 9/14/2018

VAERS ID: 424300 Before After
VAERS Form:1
Age:0.34
Sex:Male
Location:Kentucky
Vaccinated:2011-05-18
Onset:0000-00-00
Submitted:2011-05-25
Entered:2011-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (NO BRAND NAME) / SANOFI PASTEUR C3548AA / 2 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 915706 / 2 LL / IM

Administered by: Public      Purchased by: Public
Symptoms: Asphyxia, Death, Unresponsive to stimuli, Autopsy

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-05-20
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: Born addicted to drugs. Weaned off morphine & phenobarbital.
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: No known vaccine adverse reactions; parents report father rolled over on infant found unresponsive per mother; preliminary autopsy: asphyxiation per suffocation.


Changed on 10/14/2018

VAERS ID: 424300 Before After
VAERS Form:1
Age:0.34
Sex:Male
Location:Kentucky
Vaccinated:2011-05-18
Onset:0000-00-00
Submitted:2011-05-25
Entered:2011-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (NO BRAND NAME) / SANOFI PASTEUR C3548AA / 2 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 915706 / 2 LL / IM

Administered by: Public      Purchased by: Public
Symptoms: Asphyxia, Death, Unresponsive to stimuli, Autopsy

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-05-20
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: Born addicted to drugs. Weaned off morphine & phenobarbital.
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: No known vaccine adverse reactions; parents report father rolled over on infant found unresponsive per mother; preliminary autopsy: asphyxiation per suffocation.


Changed on 12/24/2020

VAERS ID: 424300 Before After
VAERS Form:1
Age:0.34
Sex:Male
Location:Kentucky
Vaccinated:2011-05-18
Onset:0000-00-00
Submitted:2011-05-25
Entered:2011-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (NO BRAND NAME) / SANOFI PASTEUR C3548AA / 2 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 915706 / 2 LL / IM

Administered by: Public      Purchased by: Public
Symptoms: Asphyxia, Death, Unresponsive to stimuli, Autopsy

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-05-20
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: Born addicted to drugs. Weaned off morphine & phenobarbital.
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: No known vaccine adverse reactions; parents report father rolled over on infant found unresponsive per mother; preliminary autopsy: asphyxiation per suffocation.


Changed on 12/30/2020

VAERS ID: 424300 Before After
VAERS Form:1
Age:0.34
Sex:Male
Location:Kentucky
Vaccinated:2011-05-18
Onset:0000-00-00
Submitted:2011-05-25
Entered:2011-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (NO BRAND NAME) / SANOFI PASTEUR C3548AA / 2 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 915706 / 2 LL / IM

Administered by: Public      Purchased by: Public
Symptoms: Asphyxia, Death, Unresponsive to stimuli, Autopsy

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-05-20
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: Born addicted to drugs. Weaned off morphine & phenobarbital.
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: No known vaccine adverse reactions; parents report father rolled over on infant found unresponsive per mother; preliminary autopsy: asphyxiation per suffocation.


Changed on 5/7/2021

VAERS ID: 424300 Before After
VAERS Form:1
Age:0.34
Sex:Male
Location:Kentucky
Vaccinated:2011-05-18
Onset:0000-00-00
Submitted:2011-05-25
Entered:2011-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (NO BRAND NAME) / SANOFI PASTEUR C3548AA / 2 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 915706 / 2 LL / IM

Administered by: Public      Purchased by: Public
Symptoms: Asphyxia, Death, Unresponsive to stimuli, Autopsy

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-05-20
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: Born addicted to drugs. Weaned off morphine & phenobarbital.
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: No known vaccine adverse reactions; parents report father rolled over on infant found unresponsive per mother; preliminary autopsy: asphyxiation per suffocation.


Changed on 5/14/2021

VAERS ID: 424300 Before After
VAERS Form:1
Age:0.34
Sex:Male
Location:Kentucky
Vaccinated:2011-05-18
Onset:0000-00-00
Submitted:2011-05-25
Entered:2011-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (NO BRAND NAME) / SANOFI PASTEUR C3548AA / 2 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 915706 / 2 LL / IM

Administered by: Public      Purchased by: Public
Symptoms: Asphyxia, Death, Unresponsive to stimuli, Autopsy

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-05-20
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: Born addicted to drugs. Weaned off morphine & phenobarbital.
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: No known vaccine adverse reactions; parents report father rolled over on infant found unresponsive per mother; preliminary autopsy: asphyxiation per suffocation.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=424300&WAYBACKHISTORY=ON


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