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This is VAERS ID 462383

Case Details

VAERS ID: 462383 (history)  
Form: Version 1.0  
Age: 0.18  
Sex: Female  
Location: Georgia  
Vaccinated:2012-05-24
Onset:2012-05-27
   Days after vaccination:3
Submitted: 2012-08-13
   Days after onset:78
Entered: 2012-08-20
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C4156AB / 1 LL / UN
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1481AA / 2 LL / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 917245 / 1 RL / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1540AA / 1 MO / PO

Administered by: Private       Purchased by: Public
Symptoms: Bed sharing, Death, Sudden infant death syndrome
SMQs:, Neonatal disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2012-05-27
   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: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: We would like to report that this death occurred within one week of 2 month vaccines. Coroner reported cause of death undetermined - possible SIDS vs. co-sleeping.


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