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This is VAERS ID 466002

History of Changes from the VAERS Wayback Machine

First Appeared on 10/14/2012

VAERS ID: 466002
VAERS Form:
Age:0.2
Sex:Male
Location:Utah
Vaccinated:2012-06-25
Onset:2012-06-26
Submitted:2012-07-19
Entered:2012-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B305 / 0 LL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0254AA / 0 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH F89912 / 0 RL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0677AA / 0 - / PO

Administered by: Private      Purchased by: Private
Symptoms: Death, Autopsy, Toxicologic test

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-06-26
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: Dexamethasone 2mg
Current Illness: Viral Croup
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Toxicology pending / autopsy results pending
CDC 'Split Type':

Write-up: Patient seen in office for well child check, normal healthy child with viral symptoms. Immunizations performed, child tolerated well. Following morning found deceased.


Changed on 5/13/2013

VAERS ID: 466002 Before After
VAERS Form:
Age:0.2
Sex:Male
Location:Utah
Vaccinated:2012-06-25
Onset:2012-06-26
Submitted:2012-07-19
Entered:2012-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B305 / 0 LL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0254AA / 0 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH F89912 / 0 RL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0677AA / 0 - / PO
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0677AA / 0 - / PO

Administered by: Private      Purchased by: Private
Symptoms: Death, Autopsy, Toxicologic test

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-06-26
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: Dexamethasone 2mg
Current Illness: Viral Croup
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Toxicology pending / autopsy results pending
CDC 'Split Type':

Write-up: Patient seen in office for well child check, normal healthy child with viral symptoms. Immunizations performed, child tolerated well. Following morning found deceased.


Changed on 6/14/2014

VAERS ID: 466002 Before After
VAERS Form:
Age:0.2
Sex:Male
Location:Utah
Vaccinated:2012-06-25
Onset:2012-06-26
Submitted:2012-07-19
Entered:2012-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B305 / 0 LL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0254AA / 0 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH F89912 / 0 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0677AA / 0 - / PO

Administered by: Private      Purchased by: Private
Symptoms: Death, Autopsy, Toxicologic test

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-06-26
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: Dexamethasone 2mg
Current Illness: Viral Croup
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Toxicology pending / autopsy results pending
CDC 'Split Type':

Write-up: Patient seen in office for well child check, normal healthy child with viral symptoms. Immunizations performed, child tolerated well. Following morning found deceased.


Changed on 2/14/2017

VAERS ID: 466002 Before After
VAERS Form:
Age:0.2 0.17
Sex:Male
Location:Utah
Vaccinated:2012-06-25
Onset:2012-06-26
Submitted:2012-07-19
Entered:2012-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B305 / 0 LL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0254AA / 0 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH F89912 / 0 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0677AA / 0 - / PO

Administered by: Private      Purchased by: Private
Symptoms: Death, Autopsy, Toxicologic test

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-06-26
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: Viral Croup
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Toxicology pending / autopsy results pending
CDC 'Split Type':

Write-up: Patient seen in office for well child check, normal healthy child with viral symptoms. Immunizations performed, child tolerated well. Following morning found deceased.


Changed on 4/14/2017

VAERS ID: 466002 Before After
VAERS Form:
Age:0.17
Sex:Male
Location:Utah
Vaccinated:2012-06-25
Onset:2012-06-26
Submitted:2012-07-19
Entered:2012-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B305 / 0 LL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0254AA / 0 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH F89912 / 0 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0677AA / 0 - / PO

Administered by: Private      Purchased by: Private
Symptoms: Death, Autopsy, Toxicologic test

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-06-26
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: Dexamethasone 2mg
Current Illness: Viral Croup
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Toxicology pending / autopsy results pending
CDC 'Split Type':

Write-up: Patient seen in office for well child check, normal healthy child with viral symptoms. Immunizations performed, child tolerated well. Following morning found deceased.


Changed on 9/14/2017

VAERS ID: 466002 Before After
VAERS Form:(blank) 1
Age:0.17
Sex:Male
Location:Utah
Vaccinated:2012-06-25
Onset:2012-06-26
Submitted:2012-07-19
Entered:2012-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B305 / 0 1 LL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0254AA / 0 1 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH F89912 / 0 1 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0677AA / 0 1 - MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Death, Autopsy, Toxicologic test

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-06-26
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: Dexamethasone 2mg
Current Illness: Viral Croup
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Toxicology pending / autopsy results pending
CDC 'Split Type':

Write-up: Patient seen in office for well child check, normal healthy child with viral symptoms. Immunizations performed, child tolerated well. Following morning found deceased.


Changed on 2/14/2018

VAERS ID: 466002 Before After
VAERS Form:1
Age:0.17
Sex:Male
Location:Utah
Vaccinated:2012-06-25
Onset:2012-06-26
Submitted:2012-07-19
Entered:2012-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B305 / 1 LL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0254AA / 1 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH F89912 / 1 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0677AA / 1 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Death, Autopsy, Toxicologic test

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-06-26
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: Dexamethasone 2mg
Current Illness: Viral Croup
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Toxicology pending / autopsy results pending
CDC 'Split Type':

Write-up: Patient seen in office for well child check, normal healthy child with viral symptoms. Immunizations performed, child tolerated well. Following morning found deceased.


Changed on 6/14/2018

VAERS ID: 466002 Before After
VAERS Form:1
Age:0.17
Sex:Male
Location:Utah
Vaccinated:2012-06-25
Onset:2012-06-26
Submitted:2012-07-19
Entered:2012-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B305 / 1 LL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0254AA / 1 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH F89912 / 1 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0677AA / 1 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Death, Autopsy, Toxicologic test

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-06-26
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: Dexamethasone 2mg
Current Illness: Viral Croup
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Toxicology pending / autopsy results pending
CDC 'Split Type':

Write-up: Patient seen in office for well child check, normal healthy child with viral symptoms. Immunizations performed, child tolerated well. Following morning found deceased.


Changed on 8/14/2018

VAERS ID: 466002 Before After
VAERS Form:1
Age:0.17
Sex:Male
Location:Utah
Vaccinated:2012-06-25
Onset:2012-06-26
Submitted:2012-07-19
Entered:2012-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B305 / 1 LL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0254AA / 1 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH F89912 / 1 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0677AA / 1 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Death, Autopsy, Toxicologic test

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-06-26
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: Dexamethasone 2mg
Current Illness: Viral Croup
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Toxicology pending / autopsy results pending
CDC 'Split Type':

Write-up: Patient seen in office for well child check, normal healthy child with viral symptoms. Immunizations performed, child tolerated well. Following morning found deceased.


Changed on 9/14/2018

VAERS ID: 466002 Before After
VAERS Form:1
Age:0.17
Sex:Male
Location:Utah
Vaccinated:2012-06-25
Onset:2012-06-26
Submitted:2012-07-19
Entered:2012-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B305 / 1 LL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0254AA / 1 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH F89912 / 1 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0677AA / 1 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Death, Autopsy, Toxicologic test

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-06-26
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: Dexamethasone 2mg
Current Illness: Viral Croup
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Toxicology pending / autopsy results pending
CDC 'Split Type':

Write-up: Patient seen in office for well child check, normal healthy child with viral symptoms. Immunizations performed, child tolerated well. Following morning found deceased.


Changed on 10/14/2018

VAERS ID: 466002 Before After
VAERS Form:1
Age:0.17
Sex:Male
Location:Utah
Vaccinated:2012-06-25
Onset:2012-06-26
Submitted:2012-07-19
Entered:2012-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B305 / 1 LL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0254AA / 1 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH F89912 / 1 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0677AA / 1 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Death, Autopsy, Toxicologic test

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-06-26
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: Dexamethasone 2mg
Current Illness: Viral Croup
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Toxicology pending / autopsy results pending
CDC 'Split Type':

Write-up: Patient seen in office for well child check, normal healthy child with viral symptoms. Immunizations performed, child tolerated well. Following morning found deceased.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=466002&WAYBACKHISTORY=ON


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