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This is VAERS ID 477044

History of Changes from the VAERS Wayback Machine

First Appeared on 12/11/2012

VAERS ID: 477044
VAERS Form:
Age:0.2
Sex:Male
Location:Illinois
Vaccinated:2012-11-29
Onset:2012-12-01
Submitted:2012-12-07
Entered:2012-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C4293AA / 0 RL / UN
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0384AE / 1 LL / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F95942 / 0 LL / UN

Administered by: Private      Purchased by: Private
Symptoms: Unresponsive to stimuli, Autopsy

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-12-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Coroners case - post inconclusive, other studies are pending
CDC 'Split Type':

Write-up: ER informed me 12-1-12 that child brought to ER after being found unresponsive in parent''s bed.


Changed on 2/14/2017

VAERS ID: 477044 Before After
VAERS Form:
Age:0.2 0.17
Sex:Male
Location:Illinois
Vaccinated:2012-11-29
Onset:2012-12-01
Submitted:2012-12-07
Entered:2012-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C4293AA / 0 RL / UN
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0384AE / 1 LL / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F95942 / 0 LL / UN

Administered by: Private      Purchased by: Private
Symptoms: Unresponsive to stimuli, Autopsy

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-12-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Coroners case - post inconclusive, other studies are pending
CDC 'Split Type':

Write-up: ER informed me 12-1-12 that child brought to ER after being found unresponsive in parent''s bed.


Changed on 9/14/2017

VAERS ID: 477044 Before After
VAERS Form:(blank) 1
Age:0.17
Sex:Male
Location:Illinois
Vaccinated:2012-11-29
Onset:2012-12-01
Submitted:2012-12-07
Entered:2012-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C4293AA / 0 1 RL / UN
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0384AE / 1 2 LL / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F95942 / 0 1 LL / UN

Administered by: Private      Purchased by: Private
Symptoms: Unresponsive to stimuli, Autopsy

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-12-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Coroners case - post inconclusive, other studies are pending
CDC 'Split Type':

Write-up: ER informed me 12-1-12 that child brought to ER after being found unresponsive in parent''s bed.


Changed on 2/14/2018

VAERS ID: 477044 Before After
VAERS Form:1
Age:0.17
Sex:Male
Location:Illinois
Vaccinated:2012-11-29
Onset:2012-12-01
Submitted:2012-12-07
Entered:2012-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C4293AA / 1 RL / UN
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0384AE / 2 LL / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F95942 / 1 LL / UN

Administered by: Private      Purchased by: Private
Symptoms: Unresponsive to stimuli, Autopsy

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-12-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Coroners case - post inconclusive, other studies are pending
CDC 'Split Type':

Write-up: ER informed me 12-1-12 that child brought to ER after being found unresponsive in parent''s bed.


Changed on 6/14/2018

VAERS ID: 477044 Before After
VAERS Form:1
Age:0.17
Sex:Male
Location:Illinois
Vaccinated:2012-11-29
Onset:2012-12-01
Submitted:2012-12-07
Entered:2012-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C4293AA / 1 RL / UN
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0384AE / 2 LL / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F95942 / 1 LL / UN

Administered by: Private      Purchased by: Private
Symptoms: Unresponsive to stimuli, Autopsy

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-12-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Coroners case - post inconclusive, other studies are pending
CDC 'Split Type':

Write-up: ER informed me 12-1-12 that child brought to ER after being found unresponsive in parent''s bed.


Changed on 8/14/2018

VAERS ID: 477044 Before After
VAERS Form:1
Age:0.17
Sex:Male
Location:Illinois
Vaccinated:2012-11-29
Onset:2012-12-01
Submitted:2012-12-07
Entered:2012-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C4293AA / 1 RL / UN
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0384AE / 2 LL / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F95942 / 1 LL / UN

Administered by: Private      Purchased by: Private
Symptoms: Unresponsive to stimuli, Autopsy

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-12-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Coroners case - post inconclusive, other studies are pending
CDC 'Split Type':

Write-up: ER informed me 12-1-12 that child brought to ER after being found unresponsive in parent''s bed.


Changed on 9/14/2018

VAERS ID: 477044 Before After
VAERS Form:1
Age:0.17
Sex:Male
Location:Illinois
Vaccinated:2012-11-29
Onset:2012-12-01
Submitted:2012-12-07
Entered:2012-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C4293AA / 1 RL / UN
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0384AE / 2 LL / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F95942 / 1 LL / UN

Administered by: Private      Purchased by: Private
Symptoms: Unresponsive to stimuli, Autopsy

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-12-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Coroners case - post inconclusive, other studies are pending
CDC 'Split Type':

Write-up: ER informed me 12-1-12 that child brought to ER after being found unresponsive in parent''s bed.


Changed on 10/14/2018

VAERS ID: 477044 Before After
VAERS Form:1
Age:0.17
Sex:Male
Location:Illinois
Vaccinated:2012-11-29
Onset:2012-12-01
Submitted:2012-12-07
Entered:2012-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C4293AA / 1 RL / UN
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0384AE / 2 LL / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F95942 / 1 LL / UN

Administered by: Private      Purchased by: Private
Symptoms: Unresponsive to stimuli, Autopsy

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-12-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Coroners case - post inconclusive, other studies are pending
CDC 'Split Type':

Write-up: ER informed me 12-1-12 that child brought to ER after being found unresponsive in parent''s bed.

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