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This is VAERS ID 483055

History of Changes from the VAERS Wayback Machine

First Appeared on 2/13/2013

VAERS ID: 483055
VAERS Form:
Age:0.0
Sex:Female
Location:New Hampshire
Vaccinated:2012-10-05
Onset:2012-11-05
Submitted:2013-01-31
Entered:2013-01-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0384AE / 0 UN / UN

Administered by: Private      Purchased by: Public
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-11-05
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: None
Current Illness: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NH01320133

Write-up: MD visit at 1 week - healthy baby. 6 lbs 9 oz born at 39 weeks. ? SIDS death.


Changed on 9/17/2013

VAERS ID: 483055 Before After
VAERS Form:
Age:0.0
Sex:Female
Location:New Hampshire
Vaccinated:2012-10-05
Onset:2012-11-05
Submitted:2013-01-31
Entered:2013-01-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0384AE / 0 UN / UN

Administered by: Private      Purchased by: Public
Symptoms: Blood caffeine, Death, Bacterial test positive, Klebsiella test positive

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-11-05
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: None
Current Illness: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NH01320133

Write-up: MD visit at 1 week - healthy baby. 6 lbs 9 oz born at 39 weeks. ? SIDS death. The following information was obtained through follow-up and/or provided by the government. 2/11/13 Autopsy report received. Final Cause of Death: Undetermined cause of death. Additional information abstracted: Discovered unresponsive after co-sleeping with mother. Lung Culture (+) for Klebsiella pneumoniae. Heart Blood (+) for Caffeine. May represent a case of Sudden Infant Death Syndrome but the possibility of asphyxia due to overlay or smothering cannot be excluded. Cause and manner of death are therefore undetermined.


Changed on 3/14/2015

VAERS ID: 483055 Before After
VAERS Form:
Age:0.0
Sex:Female
Location:New Hampshire
Vaccinated:2012-10-05
Onset:2012-11-05
Submitted:2013-01-31
Entered:2013-01-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0384AE / 0 UN / UN

Administered by: Private      Purchased by: Public
Symptoms: Blood caffeine, Death, Bacterial test positive, Klebsiella test positive

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-11-05
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: None
Current Illness: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NH01320133

Write-up: MD visit at 1 week - healthy baby. 6 lbs 9 oz born at 39 weeks. ? SIDS death. The following information was obtained through follow-up and/or provided by the government. 2/11/13 Autopsy report received. Final Cause of Death: Undetermined cause of death. Additional information abstracted: Discovered unresponsive after co-sleeping with mother. Lung Culture (+) for Klebsiella pneumoniae. Heart Blood (+) for Caffeine. May represent a case of Sudden Infant Death Syndrome but the possibility of asphyxia due to overlay or smothering cannot be excluded. Cause and manner of death are therefore undetermined.


Changed on 9/14/2017

VAERS ID: 483055 Before After
VAERS Form:(blank) 1
Age:0.0
Sex:Female
Location:New Hampshire
Vaccinated:2012-10-05
Onset:2012-11-05
Submitted:2013-01-31
Entered:2013-01-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0384AE / 0 1 UN / UN

Administered by: Private      Purchased by: Public
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-11-05
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: None
Current Illness: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NH01320133

Write-up: MD visit at 1 week - healthy baby. 6 lbs 9 oz born at 39 weeks. ? SIDS death.


Changed on 2/14/2018

VAERS ID: 483055 Before After
VAERS Form:1
Age:0.0
Sex:Female
Location:New Hampshire
Vaccinated:2012-10-05
Onset:2012-11-05
Submitted:2013-01-31
Entered:2013-01-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0384AE / 1 UN / UN

Administered by: Private      Purchased by: Public
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-11-05
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: None
Current Illness: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NH01320133

Write-up: MD visit at 1 week - healthy baby. 6 lbs 9 oz born at 39 weeks. ? SIDS death.


Changed on 6/14/2018

VAERS ID: 483055 Before After
VAERS Form:1
Age:0.0
Sex:Female
Location:New Hampshire
Vaccinated:2012-10-05
Onset:2012-11-05
Submitted:2013-01-31
Entered:2013-01-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0384AE / 1 UN / UN

Administered by: Private      Purchased by: Public
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-11-05
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: None
Current Illness: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NH01320133

Write-up: MD visit at 1 week - healthy baby. 6 lbs 9 oz born at 39 weeks. ? SIDS death.


Changed on 8/14/2018

VAERS ID: 483055 Before After
VAERS Form:1
Age:0.0
Sex:Female
Location:New Hampshire
Vaccinated:2012-10-05
Onset:2012-11-05
Submitted:2013-01-31
Entered:2013-01-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0384AE / 1 UN / UN

Administered by: Private      Purchased by: Public
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-11-05
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: None
Current Illness: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NH01320133

Write-up: MD visit at 1 week - healthy baby. 6 lbs 9 oz born at 39 weeks. ? SIDS death.


Changed on 9/14/2018

VAERS ID: 483055 Before After
VAERS Form:1
Age:0.0
Sex:Female
Location:New Hampshire
Vaccinated:2012-10-05
Onset:2012-11-05
Submitted:2013-01-31
Entered:2013-01-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0384AE / 1 UN / UN

Administered by: Private      Purchased by: Public
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-11-05
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: None
Current Illness: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NH01320133

Write-up: MD visit at 1 week - healthy baby. 6 lbs 9 oz born at 39 weeks. ? SIDS death.


Changed on 10/14/2018

VAERS ID: 483055 Before After
VAERS Form:1
Age:0.0
Sex:Female
Location:New Hampshire
Vaccinated:2012-10-05
Onset:2012-11-05
Submitted:2013-01-31
Entered:2013-01-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0384AE / 1 UN / UN

Administered by: Private      Purchased by: Public
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-11-05
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: None
Current Illness: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NH01320133

Write-up: MD visit at 1 week - healthy baby. 6 lbs 9 oz born at 39 weeks. ? SIDS death.


Changed on 7/14/2019

VAERS ID: 483055 Before After
VAERS Form:1
Age:0.0 (blank)
Sex:Female
Location:New Hampshire
Vaccinated:2012-10-05
Onset:2012-11-05
Submitted:2013-01-31
Entered:2013-01-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0384AE / 1 UN / UN

Administered by: Private      Purchased by: Public
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-11-05
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: None
Current Illness: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NH01320133

Write-up: MD visit at 1 week - healthy baby. 6 lbs 9 oz born at 39 weeks. ? SIDS death.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=483055&WAYBACKHISTORY=ON


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