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From the 1/14/2022 release of VAERS data:

Found 301 cases where Vaccine is RV1 and Patient Died

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Case Details

This is page 3 out of 31

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VAERS ID: 455355 (history)  
Form: Version 1.0  
Age: 0.34  
Sex: Male  
Location: West Virginia  
Vaccinated:2012-04-24
Onset:2012-05-04
   Days after vaccination:10
Submitted: 2012-05-10
   Days after onset:6
Entered: 2012-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C4165AB / 2 UN / IM
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVC093AA / 2 UN / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 917245 / 2 UN / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41DB273A / 2 MO / PO

Administered by: Public       Purchased by: Unknown
Symptoms: Body temperature decreased, Cardiac arrest, Convulsion, Renal failure, Respiratory arrest, Resuscitation
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (narrow), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Convulsions (narrow), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Generalised convulsive seizures following immunisation (narrow), Chronic kidney disease (narrow), Hypersensitivity (broad), Tumour lysis syndrome (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2012-05-05
   Days after onset: 1
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Amoxicillin
Current Illness: URI/OM treated 4/20/12 -$g improved 4/24/12; no fever; GATS/ACTS GERD; Nares nl; Lungs nl; TM nl; RTM LR returning; ROM acute
Preexisting Conditions: 37 wk AGA; Apgar 6 - 1, 9 - 5; Frenulectomy 12/29/11; Neonatal screen nl
Allergies:
Diagnostic Lab Data: Seen at ER
CDC Split Type:

Write-up: Received shots on 4/24/12 (3pm appointment time). 5/4/12 went down for nap -$g checked in 90 min & not breathing. ER chart received. CPR started at scene 1543. At ER 1553 in triage. Asystole on strip. 1608 temp 96.7. By 1608 pulse without compression, epinephrine drip. Renal failure by next day. No spont respiration. Seizures (+) after event.


VAERS ID: 457374 (history)  
Form: Version 1.0  
Age: 0.19  
Sex: Female  
Location: Kentucky  
Vaccinated:2012-05-16
Onset:2012-06-10
   Days after vaccination:25
Submitted: 2012-06-13
   Days after onset:3
Entered: 2012-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B326AA / 1 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UH428AB / 1 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F30921 / 1 RL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB268A / 1 MO / PO

Administered by: Private       Purchased by: Public
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2012-06-10
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Viral gastroenteritis; diaper rash
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Infant died.


VAERS ID: 459685 (history)  
Form: Version 1.0  
Age: 0.17  
Sex: Female  
Location: Arkansas  
Vaccinated:2012-06-29
Onset:2012-06-30
   Days after vaccination:1
Submitted: 2012-07-19
   Days after onset:19
Entered: 2012-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C4195AA / 1 LL / IM
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVC044AA / 2 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F56178 / 1 RL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41CBZ68A / 1 MO / PO

Administered by: Public       Purchased by: Public
Symptoms: Death, Endotracheal intubation, Resuscitation, Unresponsive to stimuli
SMQs:, Angioedema (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Respiratory failure (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2012-06-30
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: born 5 weeks premature
Allergies:
Diagnostic Lab Data: Autopsy to be performed. Hospital records will be sent to VAERS via regular mail.
CDC Split Type: AR1216

Write-up: Found unresponsive by parents just after midnight 6/30/12, transported to local hospital with external CPR by EMS. ER able to intubate and establish HR, then transferred to another hospital. Died at 2148 on 6/30/12.


VAERS ID: 463731 (history)  
Form: Version 1.0  
Age: 0.35  
Sex: Male  
Location: New Hampshire  
Vaccinated:2012-07-11
Onset:2012-08-25
   Days after vaccination:45
Submitted: 2012-08-31
   Days after onset:6
Entered: 2012-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B329BA / 2 UN / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UH432AA / 2 UN / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F56178 / 2 UN / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41CB268A / 2 MO / PO

Administered by: Private       Purchased by: Public
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2012-08-25
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data: No
CDC Split Type: NH08312012

Write-up: Well child exam on 7-11-12. No problems at birth.


VAERS ID: 465397 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Female  
Location: Missouri  
Vaccinated:2012-08-15
Onset:2012-08-16
   Days after vaccination:1
Submitted: 2012-09-04
   Days after onset:19
Entered: 2012-09-18
   Days after submission:14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B33CE / 1 LL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0221AE / 1 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 918242 / 1 RL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB288A / 1 MO / PO

Administered by: Private       Purchased by: Public
Symptoms: Cardio-respiratory arrest, Death, Respiratory arrest, Resuscitation
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Respiratory failure (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2012-08-16
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Oral NaCl
Current Illness: Nasal congestion
Preexisting Conditions: Pre-term birth; Hyponatremia
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient found at home not breathing, CPR started. EMS continued CPR & brought patient to our ED. Patient still in full cardiopulmonary arrest. Patient never recovered heart rate.


VAERS ID: 465434 (history)  
Form: Version 1.0  
Age: 0.15  
Sex: Male  
Location: Indiana  
Vaccinated:2012-09-14
Onset:2012-09-15
   Days after vaccination:1
Submitted: 2012-09-18
   Days after onset:3
Entered: 2012-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B330CE / 1 LL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0419AE / 1 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 918246 / 1 RL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB288A / 1 MO / PO

Administered by: Public       Purchased by: Public
Symptoms: Death, Unresponsive to stimuli
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2012-09-15
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Child received vaccines on 9/14/12. Parent reported found child unresponsive on 9/15/12. Taken by ambulance to ER and pronounced.


VAERS ID: 473692 (history)  
Form: Version 1.0  
Age: 0.15  
Sex: Female  
Location: Arkansas  
Vaccinated:2012-10-30
Onset:2012-11-04
   Days after vaccination:5
Submitted: 2012-11-08
   Days after onset:4
Entered: 2012-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B351AB / 1 LL / UN
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 1070AA / 1 RL / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH 918131 / 1 RL / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB27BA / 1 MO / PO

Administered by: Private       Purchased by: Public
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2012-11-04
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Fever
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Child passed away 11/4/12. Autopsy pending - cause of death unknown.


VAERS ID: 475000 (history)  
Form: Version 1.0  
Age: 0.35  
Sex: Male  
Location: Virginia  
Vaccinated:2012-11-16
Onset:2012-11-16
   Days after vaccination:0
Submitted: 2012-11-19
   Days after onset:3
Entered: 2012-11-21
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C4259AA / 2 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 918131 / 2 RL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41CB291A / 2 MO / PO

Administered by: Public       Purchased by: Public
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2012-11-19
   Days after onset: 3
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Hydronephrosis; Fussy infant/baby
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt. was taken to the hospital for sx''s of high fever. Seen by resident.


VAERS ID: 483614 (history)  
Form: Version 1.0  
Age: 0.36  
Sex: Male  
Location: South Carolina  
Vaccinated:2013-01-18
Onset:0000-00-00
Submitted: 2013-01-31
Entered: 2013-02-07
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B357BB / 2 RL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. H012570 / 2 LL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH 918175 / 2 LL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41CB305A / 2 MO / PO

Administered by: Private       Purchased by: Public
Symptoms: Autopsy, Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2013-01-21
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: No documentation of any problem. Have received word autopsy done - "child died of natural causes."


VAERS ID: 491893 (history)  
Form: Version 1.0  
Age: 0.16  
Sex: Male  
Location: Arizona  
Vaccinated:2013-04-19
Onset:2013-04-19
   Days after vaccination:0
Submitted: 2013-05-08
   Days after onset:19
Entered: 2013-05-17
   Days after submission:9
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B399BA / 1 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F45589 / 1 RL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41CB343A / 1 MO / PO

Administered by: Private       Purchased by: Unknown
Symptoms: Death, Foaming at mouth, Immediate post-injection reaction, Mouth haemorrhage, Pallor
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Convulsions (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2013-04-19
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Premature birth (21 days before the due date)
Allergies:
Diagnostic Lab Data:
CDC Split Type: AZ1307

Write-up: Immediately after the vaccines, the child looked pale and blood like foam came in the mouth. The child pooped too. The doctor came & stated after checking his mouth that he is normal and it is due to immunization.


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