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This is VAERS ID 890008

History of Changes from the VAERS Wayback Machine

First Appeared on 12/10/2020

VAERS ID: 890008
VAERS Form:2
Age:1.08
Sex:Male
Location:Texas
Vaccinated:2020-10-14
Onset:2020-10-15
Submitted:0000-00-00
Entered:2020-10-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU4: INFLUENZA (SEASONAL) (FLUZONE QUADRIVALENT) / SANOFI PASTEUR UT7081JA / 1 LL / IM

Administered by: Private      Purchased by: ??
Symptoms: Death, Influenza virus test negative, SARS-CoV-2 test negative

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2020-10-15
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: febrile seizure at 8mo after Pentacel, RotaTeq, Engerix-B, and Prevnar. Event self-resolved, never occurred again
Other Medications: Acetaminophen taken after vaccination
Current Illness: history of single febrile seizure 5/8/2020
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: COVID and flu negative
CDC 'Split Type':

Write-up: Child found deceased in bed.


Changed on 12/24/2020

VAERS ID: 890008 Before After
VAERS Form:2
Age:1.08
Sex:Male
Location:Texas
Vaccinated:2020-10-14
Onset:2020-10-15
Submitted:0000-00-00
Entered:2020-10-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU4: INFLUENZA (SEASONAL) (FLUZONE QUADRIVALENT) / SANOFI PASTEUR UT7081JA / 1 LL / IM

Administered by: Private      Purchased by: ??
Symptoms: Death, Influenza virus test negative, SARS-CoV-2 test negative

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2020-10-15
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: febrile seizure at 8mo after Pentacel, RotaTeq, Engerix-B, and Prevnar. Event self-resolved, never occurred again
Other Medications: Acetaminophen taken after vaccination
Current Illness: history of single febrile seizure 5/8/2020
Preexisting Conditions: none
Allergies: none none
Diagnostic Lab Data: COVID and flu negative
CDC 'Split Type':

Write-up: Child found deceased in bed.


Changed on 12/30/2020

VAERS ID: 890008 Before After
VAERS Form:2
Age:1.08
Sex:Male
Location:Texas
Vaccinated:2020-10-14
Onset:2020-10-15
Submitted:0000-00-00
Entered:2020-10-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU4: INFLUENZA (SEASONAL) (FLUZONE QUADRIVALENT) / SANOFI PASTEUR UT7081JA / 1 LL / IM

Administered by: Private      Purchased by: ??
Symptoms: Death, Influenza virus test negative, SARS-CoV-2 test negative

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2020-10-15
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: febrile seizure at 8mo after Pentacel, RotaTeq, Engerix-B, and Prevnar. Event self-resolved, never occurred again
Other Medications: Acetaminophen taken after vaccination
Current Illness: history of single febrile seizure 5/8/2020
Preexisting Conditions: none
Allergies: none none
Diagnostic Lab Data: COVID and flu negative
CDC 'Split Type':

Write-up: Child found deceased in bed.


Changed on 5/7/2021

VAERS ID: 890008 Before After
VAERS Form:2
Age:1.08
Sex:Male
Location:Texas
Vaccinated:2020-10-14
Onset:2020-10-15
Submitted:0000-00-00
Entered:2020-10-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU4: INFLUENZA (SEASONAL) (FLUZONE QUADRIVALENT) / SANOFI PASTEUR UT7081JA / 1 LL / IM

Administered by: Private      Purchased by: ??
Symptoms: Death, Influenza virus test negative, SARS-CoV-2 test negative

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2020-10-15
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: febrile seizure at 8mo after Pentacel, RotaTeq, Engerix-B, and Prevnar. Event self-resolved, never occurred again
Other Medications: Acetaminophen taken after vaccination
Current Illness: history of single febrile seizure 5/8/2020
Preexisting Conditions: none
Allergies: none none
Diagnostic Lab Data: COVID and flu negative
CDC 'Split Type':

Write-up: Child found deceased in bed.

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