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This is VAERS ID 463942

Case Details

VAERS ID: 463942 (history)  
Form: Version 1.0  
Age: 0.17  
Sex: Female  
Location: California  
Vaccinated:2012-08-27
Onset:2012-08-28
   Days after vaccination:1
Submitted: 2012-08-29
   Days after onset:1
Entered: 2012-09-04
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C4184AB / 1 LL / UN
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVC109BB / 2 RL / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F65441 / 1 RL / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0052AE / 1 MO / PO

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2012-08-28
   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: Baby was found dead in parents bed (she sleeps in parents bed). She was on the side with face down in the memory foam mattress. This happened on 8-28-12. Day after she received her 2 months vaccines on 8-27-12. Most probably a case of SIDS.


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