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This is VAERS ID 856698

History of Changes from the VAERS Wayback Machine

First Appeared on 2/14/2020

VAERS ID: 856698
VAERS Form:2
Age:0.17
Sex:Female
Location:Virginia
Vaccinated:2020-01-13
Onset:2020-01-14
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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: 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.


Changed on 12/24/2020

VAERS ID: 856698 Before After
VAERS Form:2
Age:0.17
Sex:Female
Location:Virginia
Vaccinated:2020-01-13
Onset:2020-01-14
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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: 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 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.


Changed on 12/30/2020

VAERS ID: 856698 Before After
VAERS Form:2
Age:0.17
Sex:Female
Location:Virginia
Vaccinated:2020-01-13
Onset:2020-01-14
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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: 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 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.


Changed on 5/7/2021

VAERS ID: 856698 Before After
VAERS Form:2
Age:0.17
Sex:Female
Location:Virginia
Vaccinated:2020-01-13
Onset:2020-01-14
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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: 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 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.


Changed on 5/14/2021

VAERS ID: 856698 Before After
VAERS Form:2
Age:0.17
Sex:Female
Location:Virginia
Vaccinated:2020-01-13
Onset:2020-01-14
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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: 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 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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