National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 469542

History of Changes from the VAERS Wayback Machine

First Appeared on 11/13/2012

VAERS ID: 469542
VAERS Form:
Age:0.2
Sex:Female
Location:Kentucky
Vaccinated:2012-09-07
Onset:2012-09-08
Submitted:0000-00-00
Entered:2012-10-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B323AA / 0 LL / UN
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 1070AA / 0 RL / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH 918242 / 0 RL / UN
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0055AE / 0 - / PO

Administered by: Public      Purchased by: Public
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-09-08
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: GER
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient expired on 9/08/2012 at 4:00 AM, in her home.


Changed on 5/13/2013

VAERS ID: 469542 Before After
VAERS Form:
Age:0.2
Sex:Female
Location:Kentucky
Vaccinated:2012-09-07
Onset:2012-09-08
Submitted:0000-00-00
Entered:2012-10-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B323AA / 0 LL / UN
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 1070AA / 0 RL / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH 918242 / 0 RL / UN
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0055AE / 0 - / PO
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0055AE / 0 - / PO

Administered by: Public      Purchased by: Public
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-09-08
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: GER
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient expired on 9/08/2012 at 4:00 AM, in her home.


Changed on 2/14/2017

VAERS ID: 469542 Before After
VAERS Form:
Age:0.2 0.18
Sex:Female
Location:Kentucky
Vaccinated:2012-09-07
Onset:2012-09-08
Submitted:0000-00-00
Entered:2012-10-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B323AA / 0 LL / UN
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 1070AA / 0 RL / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH 918242 / 0 RL / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0055AE / 0 - / PO

Administered by: Public      Purchased by: Public
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-09-08
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: GER
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient expired on 9/08/2012 at 4:00 AM, in her home.


Changed on 9/14/2017

VAERS ID: 469542 Before After
VAERS Form:(blank) 1
Age:0.18
Sex:Female
Location:Kentucky
Vaccinated:2012-09-07
Onset:2012-09-08
Submitted:0000-00-00
Entered:2012-10-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B323AA / 0 1 LL / UN
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 1070AA / 0 1 RL / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH 918242 / 0 1 RL / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0055AE / 0 1 - MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-09-08
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: GER
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient expired on 9/08/2012 at 4:00 AM, in her home.


Changed on 2/14/2018

VAERS ID: 469542 Before After
VAERS Form:1
Age:0.18
Sex:Female
Location:Kentucky
Vaccinated:2012-09-07
Onset:2012-09-08
Submitted:0000-00-00
Entered:2012-10-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B323AA / 1 LL / UN
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 1070AA / 1 RL / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH 918242 / 1 RL / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0055AE / 1 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-09-08
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: GER
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient expired on 9/08/2012 at 4:00 AM, in her home.


Changed on 6/14/2018

VAERS ID: 469542 Before After
VAERS Form:1
Age:0.18
Sex:Female
Location:Kentucky
Vaccinated:2012-09-07
Onset:2012-09-08
Submitted:0000-00-00
Entered:2012-10-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B323AA / 1 LL / UN
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 1070AA / 1 RL / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH 918242 / 1 RL / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0055AE / 1 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-09-08
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: GER
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient expired on 9/08/2012 at 4:00 AM, in her home.


Changed on 8/14/2018

VAERS ID: 469542 Before After
VAERS Form:1
Age:0.18
Sex:Female
Location:Kentucky
Vaccinated:2012-09-07
Onset:2012-09-08
Submitted:0000-00-00
Entered:2012-10-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B323AA / 1 LL / UN
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 1070AA / 1 RL / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH 918242 / 1 RL / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0055AE / 1 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-09-08
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: GER
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient expired on 9/08/2012 at 4:00 AM, in her home.


Changed on 9/14/2018

VAERS ID: 469542 Before After
VAERS Form:1
Age:0.18
Sex:Female
Location:Kentucky
Vaccinated:2012-09-07
Onset:2012-09-08
Submitted:0000-00-00
Entered:2012-10-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B323AA / 1 LL / UN
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 1070AA / 1 RL / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH 918242 / 1 RL / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0055AE / 1 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-09-08
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: GER
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient expired on 9/08/2012 at 4:00 AM, in her home.


Changed on 10/14/2018

VAERS ID: 469542 Before After
VAERS Form:1
Age:0.18
Sex:Female
Location:Kentucky
Vaccinated:2012-09-07
Onset:2012-09-08
Submitted:0000-00-00
Entered:2012-10-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B323AA / 1 LL / UN
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 1070AA / 1 RL / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH 918242 / 1 RL / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0055AE / 1 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-09-08
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: GER
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient expired on 9/08/2012 at 4:00 AM, in her home.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=469542&WAYBACKHISTORY=ON


Copyright © 2020 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166