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From the 5/7/2021 release of VAERS data:

This is VAERS ID 806371



Case Details

VAERS ID: 806371 (history)  
Form: Version 2.0  
Age: 0.92  
Sex: Female  
Location: Arkansas  
Vaccinated:2019-02-07
Onset:2019-02-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2019-03-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK LL / SYR
FLU4: INFLUENZA (SEASONAL) (AFLURIA QUADRIVALENT) / SEQIRUS, INC. - / UNK RL / SYR
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS - / UNK RL / SYR
HIBV: HIB (HIBERIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK RL / SYR
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR - / UNK LL / SYR
PPV: PNEUMO (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK LL / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Death, Eyelid function disorder, Febrile convulsion, Pyrexia, Urine analysis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Periorbital and eyelid disorders (narrow), Ocular motility disorders (narrow), Generalised convulsive seizures following immunisation (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2019-03-02
   Days after onset: 23
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Tylenol for pain.
Current Illness: None
Preexisting Conditions: None.
Allergies: Latex
Diagnostic Lab Data: Blood and urine testing.
CDC Split Type:

Write-up: 4 hours after my daughter got her shots her fever wouldn''t go down. At 11pm that night she begain to have complex febrial seizures. She had 3 that night. After coming home she wasn''t the same. One of her eyes didn''t open as much as it should have and she was slower. Almost a month later she died in her sleep because of another febrial seizure.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=806371


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