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

Found 498 cases where Vaccine is RV5 and Patient Died

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Case Details

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VAERS ID: 280206 (history)  
Form: Version 1.0  
Age: 0.3  
Sex: Male  
Location: Texas  
Vaccinated:2007-04-11
Onset:2007-04-12
   Days after vaccination:1
Submitted: 2007-06-01
   Days after onset:50
Entered: 2007-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B066AA / 2 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF084AA / 2 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH 836258H / 2 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0389F / 2 MO / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Feeling hot, Irritability, Skin warm, 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), Hostility/aggression (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2007-04-12
   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: Hydrocortisone cream 1%
Current Illness: None
Preexisting Conditions: Eczema PMH: atopic dermatitis, seborrheic dermatitis & eczema.
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient seen for 4 month well child check on 4/11/2007. Normal exam. Received routine vaccines. That evening, patient noted to be fussy. Improved by 10pm. Placed face down in parents bed. Mother awoke at 5am to find infant hot, unresponsive. Called EMS. Patient unable to be resuscitated and expired. 7/31/07 Received autopsy report which states COD as undetermined & manner of death as undetermined. Patient found unresponsive in prone position while co-sleeping w/parents in adult bed. Temp in ER was 103.2. No congenital anomalies or traumatic injuries found at autopsy. Tox & metabolic tests were neg. Cultures were non contributory.


VAERS ID: 282860 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Male  
Location: Illinois  
Vaccinated:2007-06-25
Onset:2007-06-25
   Days after vaccination:0
Submitted: 2007-06-26
   Days after onset:1
Entered: 2007-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B097AB / 1 LL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0066U / 1 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B26510A / 1 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0028U / 1 MO / PO

Administered by: Public       Purchased by: Public
Symptoms: 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: 2007-06-25
   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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Baby was found in crib unresponsive by a babysitter. She moved the baby to a couch until EMS arrived. Was placed in the crib at 2pm and found 1 1/2 hrs later. No fever or prodromal symptoms per the ER doctor. Unknown if Tylenol had been given. Was seen by private MD at 10am. 2/26/08 Reviewed autopsy report which states COD as undetermined. Pathologic findings: tox results neg; pulmonary vascular congestion, mild, combined weight of lungs 132 grams; petechiae of lung pleura, mild; no evidence of significant natural disease, injury, active infection, congenital anomaly, malformation metabolic disorders or malignancy.


VAERS ID: 282926 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Male  
Location: New York  
Vaccinated:2007-06-25
Onset:2007-06-26
   Days after vaccination:1
Submitted: 2007-06-27
   Days after onset:1
Entered: 2007-06-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B115AA / 1 LL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 006511 / 1 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH BO8679B / 1 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1237F / 1 MO / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Body temperature increased, Death, Loss of consciousness, Viral infection
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2007-06-26
   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: recovered after a viral syndrome
Preexisting Conditions: there is a hystory of cardiac problem;no documentation available.The parent states that baby was followed up by cardiology and the echo exam was normal.
Allergies:
Diagnostic Lab Data: baby was recovering after a viral syndrome;T-98.8;full clinical exam normal the day of immunization.
CDC Split Type:

Write-up: baby was administered the Pediarix,Hib,pcv and Rotavirus;before and after the vaccine administration baby appeared in good health,stable;no adverse effect observed in clinic or home;the next morning,after being fed and put to sleep on his tummy, baby was found unconscious, face down in crib and expired in E.R. 7/3/07 Received vax records which confirm RO lot & dose # as reported. 11/27/07 Reviewed autopsy report which states COD as undetermined & manner of death undetermined. Diagnoses included: sudden death of 2 mo old baby boy sleeping prone in bassinet on blanket found face down with anterior fixed lividity on abdomen & surrounding nose & mouth; atrial septal defect, secundum type; 6 fingers on each hand.


VAERS ID: 283066 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Female  
Location: Tennessee  
Vaccinated:2007-06-18
Onset:2007-06-20
   Days after vaccination:2
Submitted: 2007-06-21
   Days after onset:1
Entered: 2007-06-28
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B090AA / 1 LL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 1013F / 1 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08689K / 1 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0940F / 1 MO / PO

Administered by: Public       Purchased by: Public
Symptoms: Death, Respiratory arrest
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Respiratory failure (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2007-06-20
   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:
CDC Split Type:

Write-up: Grandmother found baby not breathing after nap around 3:55 pm. EMS notified and CPR began 10 minutes after discovery. Baby transported with CPR in progress. Baby pronounced dead at 4:31 pm. 7/10/07 Received vax records from HD which confirms RO dose & lot # as reported. 10/2/07 Autopsy Report reviewed which states COD as SIDS.


VAERS ID: 283502 (history)  
Form: Version 1.0  
Age: 0.17  
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2007-06-29
Entered: 2007-07-02
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Death, Haematochezia
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal haemorrhage (narrow), Ischaemic colitis (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: [therapy unspecified]
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0706USA03813

Write-up: Information has been received from a physician concerning a 2-month-old patient who was vaccinated with a dose of Rotateq (lot number not provided). Concomitant therapy on that same day included "several other shots" (not further specified). The physician reported that, within 24 hours of vaccination, the patient had bloody stools and within 48 hours died. Upon internal review, bloody stools was determined to be an other important medical event. No further information is available.


VAERS ID: 284014 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Female  
Location: Indiana  
Vaccinated:2007-06-19
Onset:2007-06-29
   Days after vaccination:10
Submitted: 2007-07-06
   Days after onset:7
Entered: 2007-07-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B090BA / 1 LL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0205U / 1 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08690A / 1 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0022U / 1 MO / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms:
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2007-06-29
   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: Mother answered NO to all screening questions.
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Screening questionnaire from Immunizations all answered by mother as no. 8/7/07 Received Death Certificate from HD which reveals COD as positional asphyxia. Received Autopsy Report from Coroner which reveals COD as same w/anatomic findings of pulmonary congestion, edema & petechial hemorrhage; petechial hemorrhages of thymus & heart; mild bilateral facial cheek abrasions; facial plethora; & pericardial effusion. Report indicates patient found face down in bumper of the bed. Manner of death is accidental.


VAERS ID: 284759 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Male  
Location: Kentucky  
Vaccinated:2007-06-21
Onset:2007-06-26
   Days after vaccination:5
Submitted: 2007-07-16
   Days after onset:20
Entered: 2007-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR U2059AA / 1 RL / IM
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 1242F / 1 LL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR Z0326 / 1 RL / SC
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B58845C / 1 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0506U / 1 MO / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2007-06-26
   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: None reported by mother
Current Illness: None reported by mother
Preexisting Conditions: None reported by mother
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: On 6/28/07, received report of infant death from Coroner''s Office. 7/17/07 T/C to coroner to request prelim COD: stated as Undetermined. Patient was sleeping in bassinet using pillows & blankets as mattress & was found face down. 8/24/07 Received vax record which confirms RO dose & lot # as reported. 11/6/07 Received death certificate & autopsy report which state COD as undetermined in setting of non-standard (home made mattress) bedding in which patient was placed face down.


VAERS ID: 287884 (history)  
Form: Version 1.0  
Age: 0.17  
Sex: Male  
Location: New York  
Vaccinated:2007-06-22
Onset:2007-06-30
   Days after vaccination:8
Submitted: 2007-08-10
   Days after onset:41
Entered: 2007-08-13
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / UN
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. - / UNK UN / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH - / UNK UN / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / UNK MO / PO
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Autopsy, Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2007-06-30
   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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0708USA00914

Write-up: Information has been received from a physician concerning a 2-month-old male who on 22-JUN-2007 was vaccinated with a 2mL PO dose of Rotateq (Lot # "2028U"). Suspect therapy that day included a dose of HIB conj-hepatitis B vaccine, a dose of PREVNAR, a dose of diphtheria toxoid (+) pertussis acellular vaccine (unspecified) (+) tetanus toxoid, and a dose of "ITV". On 30-JUN-2007 the patient passed away. CPR was noted. The autopsy medical examiner gave verbal to the mother stating that no cause has been determined. At the time of the report, the physician still did not have the autopsy report. No further information was provided. There was no product quality complaint. The event was considered to be an other important medical event by the reporter. Additional information has been requested.


VAERS ID: 288180 (history)  
Form: Version 1.0  
Age: 0.19  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2007-07-17
Onset:2007-07-18
   Days after vaccination:1
Submitted: 2007-08-15
   Days after onset:28
Entered: 2007-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B127AA / 1 UN / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0078U / 1 UN / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08679C / 1 UN / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0578F / 1 MO / PO

Administered by: Private       Purchased by: Public
Symptoms: Acidosis, Brain damage, Cardio-respiratory arrest, Culture negative, Intensive care, Pulse absent, Respiratory arrest
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Lactic acidosis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), 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), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypersensitivity (broad), Tumour lysis syndrome (broad), Respiratory failure (narrow)

Life Threatening? Yes
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: TYENOL prescribed
Current Illness: none
Preexisting Conditions: prematurity 31 weeks 12/28/07-records received-31 week premature
Allergies:
Diagnostic Lab Data: Intitial pH=6.8 7/18 8am. All cultures negative 12/28/07-records received- EEG revealed bilateral cerebral dysfunction with right temporal epileptiform activity and no reactivity to stimulation. MRI diffuse cystic change with volume loss.
CDC Split Type:

Write-up: Patient received vaccinations on 7/17 pm. Mother reported no illness or fever. Mother reported normal feeding that evening and in the morning. On 7/18 am, mother reported feeding the baby and then putting in crib after feeding finished. Baby did not move when put in crib and found to be not breathing by mom. 911 called and child was found to be in pulseless arrest. CPR performed for 25 minutes or more before pulse restored in ER. Child has been in PICU with evidence of brain damage since then.


VAERS ID: 288471 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Female  
Location: California  
Vaccinated:2007-08-16
Onset:2007-08-17
   Days after vaccination:1
Submitted: 2007-08-20
   Days after onset:3
Entered: 2007-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B114BB / 1 - / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0077U / 1 - / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08700H / 1 - / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0971U / 1 MO / PO

Administered by: Private       Purchased by: Public
Symptoms: Respiratory arrest, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), Respiratory failure (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2007-08-17
   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: Infant Tylenol
Current Illness: None
Preexisting Conditions: None Umbilical hernia
Allergies:
Diagnostic Lab Data: Unavailable Autopsy Findings: Acetaminophen level 13 mg/L & CAH 17-OHP level abnormal.
CDC Split Type:

Write-up: Prelim reported that pt''s vomited and gone to respiratory arrest. 8/21/07 Spoke w/MD who states patient was in good health on day of vax. Looked tired but exam was WNL. Family concerned only about umbilical hernia. 8/21/07 Received pcp medical records & vax records which confirm RO dose & lot # as reported. Records indicate patient was in good health on day of vax w/only medical concern umbilical hernia. 3/11/08 Autopsy report states COD as undetermined.


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