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From the 1/7/2022 release of VAERS data:

Found 497 cases where Vaccine is RV5 and Patient Died

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Case Details

This is page 5 out of 50

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VAERS ID: 289100 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Male  
Location: Illinois  
Vaccinated:2007-08-23
Onset:2007-08-24
   Days after vaccination:1
Submitted: 2007-08-27
   Days after onset:3
Entered: 2007-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B115AA / 1 LL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0077U / 1 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B53981A / 1 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0508U / 1 MO / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Death, Developmental delay, Failure to thrive
SMQs:, Neonatal disorders (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2007-08-25
   Days after onset: 1
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: Microcephalus, underweight BIRTH HX: 38-wk emergency c-section due to deceleration, nuchal cord & decreased amniotic fluid. 6 days in NICU. Parents are 1st cousins (+ consanguinity). Had 5yo sibling deceased w/similar s/s & seizure disorder, apnea & flat head.
Allergies:
Diagnostic Lab Data: LABS: MRI at birth showed areas of hypoplasia of corpus callosum. Echocardiogram done during resuscitation revealed very wide QRS & bradycardia which progressed to EMD w/o any mechanical cardiac funation. Abdomen KUB revealed nonspecific nonobstructive bowel gas patter w/paucity of small bowel gas. CXR WNL. Blood c/s (+) for bacillus species but may have been contaminant.
CDC Split Type:

Write-up: Patient died two days after receiving vaccines. Infant had multiple problems including failure to thrive, and developmental delays. Was admitted with complete heart block. 8/28/07 Spoke w/the reporter on this case who will provide medical records from clinic & hospital as well as a copy of the Death Certificate. No autopsy was done. Reporter stated this child had multiple medical problems & was being followed by several clinic specialists including geneticist. Sibling of this child also had multiple problems & expired at unknown time. 9/7/07 Reviewed medical records & Death Certifiate from reporter. COD stated as complete heart block w/microcephaly & failure to thrive as contributing factors. Vax record confirms dose & Lot # of all vax as reported. Had microcephaly, hypertonia & contractures of UEs noted on d/c from birth hospital. Referred by birth hospital to Easter Seals for developmental therapy eval 7/07. Medical records show that on day of vax had cough & sneeze along w/very slow feeding & poor growth noted. Referred for feeding eval. PCP records indicate patient on home monitor. Neuro, Genetic & Cardio consults. Very slowly gained weight & remained significantly underweight. Genetics eval done 7/07. Developmental delay. Cardiac consult on day of death reveals patient admitted 8/24 for diarrhea & poor feeding then developed slow heart rate & complete heart block. FINAL DX: complete heart block, microcephaly & failure to thrive.


VAERS ID: 289543 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Male  
Location: California  
Vaccinated:2007-08-09
Onset:2007-08-10
   Days after vaccination:1
Submitted: 2007-08-13
   Days after onset:3
Entered: 2007-08-31
   Days after submission:18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B124AA / 1 RL / UN
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0077U / 1 LL / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B540138 / 1 LL / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1238F / 1 MO / PO

Administered by: Private       Purchased by: Unknown
Symptoms: Diet refusal, Gaze palsy, Respiratory arrest, Resuscitation
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Ocular motility disorders (narrow), Hypersensitivity (broad), Respiratory failure (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2007-08-10
   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: Nystatin suspension
Current Illness: thrush, oral umbilical hernia
Preexisting Conditions: sickle-cell trait
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Per ER call to on call physician 8/11. Last night he stopped feeding and then his eyes rolled back and he stopped breathing. 911 called and CPR initiated. Coded for 1-1/2 hours (paramedics and ER) without success. 9/4/07 Received pcp medical records which included vax record which confirmed RO dose & lot #s as reported. Office note of 8/9 indicates well child visit on day of vax excep for thrush & umbilical hernia. 1/8/08 Reviewed autopsy report which states COD as sudden unexplained infant death syndrome due to dilated cardiomyopathy & primary endocardial fibroelastosis, dilated form.


VAERS ID: 290673 (history)  
Form: Version 1.0  
Age: 0.3  
Sex: Male  
Location: Missouri  
Vaccinated:2007-08-28
Onset:0000-00-00
Submitted: 2007-09-07
Entered: 2007-09-17
   Days after submission:10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2657AA / 2 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF169AA / 2 LL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR Z1009 / 2 RL / SC
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B26510K / 2 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0972U / 2 MO / PO

Administered by: Private       Purchased by: Private
Symptoms: Autopsy, Sudden infant death syndrome, 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), Neonatal disorders (narrow), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2007-09-02
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: None PMH: Nasal congestion. Birth Hx: c-section. Mother smoker & diabetic.
Allergies:
Diagnostic Lab Data: Autopsy report pending
CDC Split Type:

Write-up: Sudden infant death. Family visiting relatives found baby unresponsive in crib. 6/13/08 Autopsy report states COD as SIDS. Report states patient traveled with family out of state over holiday w/e. Placed in portable crib for nap. Found unresponsive & cool approx 3 hrs later. CPR started & EMS called but no pulse or respirations.


VAERS ID: 290781 (history)  
Form: Version 1.0  
Age: 0.36  
Sex: Male  
Location: Idaho  
Vaccinated:2007-08-21
Onset:2007-09-04
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2007-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B133AA / 2 RL / IM
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVA066AA / 3 UN / UN
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0079U / 2 LL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR KO772 / 2 UN / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B540076 / 2 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0941U / 2 MO / PO

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2007-09-04
   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: None
Current Illness: No
Preexisting Conditions: (L) finger hemangioma PMH: umiblical hernia, GERD, hemangioma on finger, vomiting & pyloric stenosis ruled out by abd sonogram WNL, thrush Birth Hx: 39 wk c-section. 7 lbs 6 oz. Family Hx: eczema, migraines, asthma.
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: None stated. 9/18/07 T/C to reporter/provider to clarify reported death. Box 7 blank on form. Message left for return call. 9/20/07 T/C to reporter. Message left. 9/25/07 T/C to reporter. Stated patient did expire. Autopsy requested. Preliminary COD is pending but coroner indicated to MD that is probably SIDS. Reporter stated patient had no health problems or birth complications. Letter faxed to request vax record./ss 9/28/07 Linked w/291475. 10/9/07 Reviewed pcp medical records which reveal patient experienced good health on day of vax. Vax records indicate RO dose & lot # correct as reported but other vax corrections made in VAERS database. 11/6/07 Reviewed Autopsy report which states COD as sudden unexplained death in infancy. Had been placed in crib face up & then found unresponsive when later checked.


VAERS ID: 290946 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Male  
Location: New York  
Vaccinated:2007-09-19
Onset:2007-09-20
   Days after vaccination:1
Submitted: 2007-09-20
   Days after onset:0
Entered: 2007-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B110A / 1 RL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0076U / 1 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08679E / 1 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0669U / 1 MO / PO

Administered by: Other       Purchased by: Public
Symptoms: Cyanosis, Death, Irritability
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (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: 2007-09-20
   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: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: 2 month complete physical exam - WNL
CDC Split Type:

Write-up: On 9/19/07 between 11:30-12N child received 4 vaccinations (see below). Dr saw infant 3 hrs later and he appeared well. Parents state between 6p-8p infant fussy. In AM of 9/20/07 child found "blue" 911 called but infant died.


VAERS ID: 291476 (history)  
Form: Version 1.0  
Age: 0.3  
Sex: Male  
Location: Idaho  
Vaccinated:2007-09-12
Onset:2007-09-15
   Days after vaccination:3
Submitted: 2007-09-26
   Days after onset:11
Entered: 2007-09-27
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B124B / 2 UN / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B54007C / 2 UN / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0968U / 2 UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Autopsy, Peripheral coldness, Sudden infant death syndrome, 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), Neonatal disorders (narrow), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2007-09-15
   Days after onset: 0
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown PMH: circumcised but buried penis in adhesions. right parietal cephalohematoma, 2 cm in diameter. Birth Hx: 41 wk emergent c-section for failure to dilate, 7 lbs 14 oz. jaundice.
Allergies:
Diagnostic Lab Data: autopsy - pending
CDC Split Type: WAES0709USA03810

Write-up: Information has been received from a physician concerning a 17-week-old male who on 12-Sep-2007 was vaccinated with a dose of Rotateq (lot# 656838/0968U). Suspect vaccination included PedvaxHib (manufacturer unknown). Concomitant vaccinations included Pediarix and Prevnar (it was noted that the patient did not receive MMR II and Varivax). On 14-Sep-2007, the parents put the infant to sleep on his back. The infant had a pacifier and no blankets in the crib. At midnight, when the parents checked on him, he was fine. When the parents checked on him at 6am on 15-Sep-2007, he was unresponsive and cold. 911 was called and the baby was coded. The infant was dead on arrival to the hospital. The cause of death was sudden infant death syndrome. No product quality complaint was involved. This is one of several reports from the same reporter. Sudden infant death syndrome was considered to be disabling and life threatening. Autopsy results will provided when they become available. Additional information has been requested. 10/9/07 Reviewed pcp medical records which reveal patient was in good health on day of vax. Vax records reveal RO lot # correct as reported & was Dose #2. Other vax updated in VAERS database. 11/16/07 Received autopsy report which states COD as sudden unexplained death during infancy.


VAERS ID: 291803 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Female  
Location: California  
Vaccinated:2007-09-21
Onset:2007-09-22
   Days after vaccination:1
Submitted: 2007-09-27
   Days after onset:5
Entered: 2007-10-02
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS SKBAC21B129AC / 1 RL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. MSD0072U / 1 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH WAL608700A / 1 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. MSD0876U / 1 MO / PO

Administered by: Unknown       Purchased by: Public
Symptoms: Chest X-ray abnormal
SMQs:, Cardiomyopathy (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2007-09-23
   Days after onset: 1
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Seborrhea
Preexisting Conditions: Prematurity - 33 weeks BW 4 lbs 0 oz. PMH: 33 wk preemie. 14 days in NICU.
Allergies:
Diagnostic Lab Data: CXR from 9/20/07 with enlarged ht/ enlarged left ventricular prominent/ distended abdomen
CDC Split Type:

Write-up: Child received vaccines on 9/21/07 child brought to ER in full arrest 9/22 late /9/23 early am ---$g died report of autopsy pending. 12/18/07 Reviewed autopsy report which reveals COD as SIDS. Patient co-sleeping w/parent in twin size bed. Found unresponsive w/blood in nose when parent awoke.


VAERS ID: 293421 (history)  
Form: Version 1.0  
Age: 0.3  
Sex: Male  
Location: Florida  
Vaccinated:2007-10-01
Onset:2007-10-04
   Days after vaccination:3
Submitted: 2007-10-13
   Days after onset:9
Entered: 2007-10-17
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B133BA / 2 UN / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0073U / 2 UN / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B5007H / 2 UN / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0240U / 2 MO / PO

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2007-10-04
   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: None
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Death 11/27/07 Reviewed vax record which confirms dose & lot #s as reported. 4/15/08 Autopsy report states COD as anoxic/hypoxic encephalopathy & bronchopneumonia due to infantile reflux & aspiration while sleeping.


VAERS ID: 294509 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Female  
Location: Tennessee  
Vaccinated:2007-10-08
Onset:2007-10-09
   Days after vaccination:1
Submitted: 2007-10-26
   Days after onset:17
Entered: 2007-10-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B130AA / 1 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF205AA / 1 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08702C / 1 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0941U / 1 MO / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Autopsy, Body temperature increased, Death, Pulse absent, Respiratory arrest, Resuscitation
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (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), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2007-10-09
   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: Acetaminophen 40mg given immediately after vaccinations. By report the family gave the same amount again at about 07:00pm on 10/08/2007.
Current Illness: None.
Preexisting Conditions: None.
Allergies:
Diagnostic Lab Data: Autopsy results pending.
CDC Split Type:

Write-up: Mother awakened in early morning and noticed that patient was not breathing or moving. Resuscitation attempted by father and by EMS and hospital personnel. By report, first recorded temperature during resuscitation was 102 F. Pulse was never reported to have been attained. 4/1/08 Autopsy report states COD as sudden unexplained infant death & manner of death not determined. Report states patient had recent URI. Found unresponsive on soft pillow on couch w/parent.


VAERS ID: 296075 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Female  
Location: Kentucky  
Vaccinated:2007-10-29
Onset:2007-10-30
   Days after vaccination:1
Submitted: 2007-10-30
   Days after onset:0
Entered: 2007-11-08
   Days after submission:9
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2607AA / 1 LL / IM
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 1158F / 2 LL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR 21009 / 1 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH 853981 / 1 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 05084 / 1 UN / UN

Administered by: Private       Purchased by: Private
Symptoms:
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2007-10-30
   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: Nystatin
Current Illness: constipation, thrush
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: death. 12/17/07 Reviewed autopsy report which states COD as SIDS. Patient found in crib lying on back & unresponsive. 12/17/07 Received vax record & medical records which confirm vax dose & lot #s as reported. Patient had thrush & was constipated during office visit 10/29/07, otherwise, healthy.


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