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From the 9/17/2021 release of VAERS data:

This is VAERS ID 856698



Case Details

VAERS ID: 856698 (history)  
Form: Version 2.0  
Age: 0.17  
Sex: Female  
Location: Virginia  
Vaccinated:2020-01-13
Onset:2020-01-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2020-01-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS K7TF9 / 1 RL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. S000355 / 1 LL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH AA7118 / 1 LL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS 4PP5L / 1 MO / PO

Administered by: Military       Purchased by: ?
Symptoms: Chest X-ray, Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: VITAMIN D DROPS 10 MCG/ML-400 UNITS PER ML HYDROCORTISONE CREAM 1% APPLY TO AFFECTED AREAS 2 TO 3 TIMES DAILY TO AFFECTED AREAS EMOLLIENT BASE CREAM TOPICAL APPLY AFFECTED AREAS TWICE A DAY ON BODY AND FACE FOR DRY SKIN ESOMEPRAZOLE MAG 2.
Current Illness: NEWBORN RASH V/S ATOPIC ECZEMA V/S MILARIA RUBRA "NOISY BREATHING" REFERRAL PLACED TO ENT
Preexisting Conditions: NONE
Allergies: NO KNOWN DRUG ALLERIES
Diagnostic Lab Data: AN X-RAY WAS DONE THE DAY OF WELL BABY EXAM FOR "NOISY BREATHING". A REFERRAL WAS PLACED FOR PATIENT BY THE PROVIDER TO AN ENT FOR EVALUATION. THIS IS THE DAY THE VACCINES WERE ADMINISTERED.
CDC Split Type:

Write-up: PARENT REPORTED INFANT DEATH. PATIENT WAS FOUND IN CRIB, FACE DOWN DECEASED ON 01/13/2020 IN THE AFTERNOON.


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