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From the 11/26/2021 release of VAERS data:

Found 1,713 cases where Vaccine is 6VAX-F or DPIPV or DPP or DTAPHEPBIP or DTAPIPV or DTAPIPVHIB or DTIPV or DTPIHI or DTPIPV or DTPPHIB or IPV or TDAPIPV and Patient Died and Submission Date on/before '2015-09-30'

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Case Details

This is page 9 out of 172

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VAERS ID: 117974 (history)  
Form: Version 1.0  
Age: 0.4  
Sex: Male  
Location: Texas  
Vaccinated:1999-01-06
Onset:1999-01-07
   Days after vaccination:1
Submitted: 1999-01-07
   Days after onset:0
Entered: 1999-01-11
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (ACEL-IMUNE) / PFIZER/WYETH 454760 / 1 LL / IM
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 2795A2 / 1 LL / IM
HIBV: HIB (ACTHIB) / CONNAUGHT LABORATORIES P0026 / 1 RL / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / PASTEUR MERIEUX INST. P0084 / 1 RL / SC

Administered by: Private       Purchased by: Private
Symptoms: Sudden infant death syndrome
SMQs:, Neonatal disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1999-01-07
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: autopsy report COD will be forward upon receipt
CDC Split Type:

Write-up: pt expired w/in 24hr of recv vax;


VAERS ID: 118144 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Male  
Location: Virginia  
Vaccinated:1998-12-29
Onset:1999-01-01
   Days after vaccination:3
Submitted: 1999-01-13
   Days after onset:12
Entered: 1999-01-19
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (ACEL-IMUNE) / PFIZER/WYETH 455725 / 1 LL / IM
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 2712A2 / 2 RL / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 0988220 / 1 RL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. N04921 / 1 LL / IM

Administered by: Private       Purchased by: Public
Symptoms: Sudden infant death syndrome
SMQs:, Neonatal disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1999-01-01
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: Rondec DM
Current Illness: mild nasal stuffiness
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy negative
CDC Split Type:

Write-up: pt was found dead by mom-65hr p/vax;2hr prior to events the mom had fed child w/o problems;


VAERS ID: 118525 (history)  
Form: Version 1.0  
Age: 0.4  
Sex: Male  
Location: Florida  
Vaccinated:1998-12-23
Onset:1998-12-23
   Days after vaccination:0
Submitted: 1999-01-21
   Days after onset:29
Entered: 1999-02-03
   Days after submission:13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 0944770 / 1 LL / -
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 2710192 / 2 RL / -
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0723H / 1 LL / -
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. N0348 / 1 LL / -

Administered by: Public       Purchased by: Public
Symptoms: Agitation, Pyrexia, Sudden infant death syndrome
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Neonatal disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1998-12-27
   Days after onset: 4
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: COD pending autopsy
CDC Split Type: FL98068

Write-up: approx 1hr p/vax pt was a little cranky & had a temp of 101 according to mom, gave APAP, no other problems noted;


VAERS ID: 118588 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Female  
Location: South Carolina  
Vaccinated:1998-12-24
Onset:1999-01-05
   Days after vaccination:12
Submitted: 1999-01-22
   Days after onset:17
Entered: 1999-02-08
   Days after submission:17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (ACEL-IMUNE) / PFIZER/WYETH 456818 / 1 RL / -
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 2726A2 / 2 RL / -
HIBV: HIB (HIBTITER) / PFIZER/WYETH 0953210 / 1 LL / -
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. NO492 / 1 LL / SC
RV: ROTAVIRUS (ROTASHIELD) / PFIZER/WYETH 4988059 / 1 MO / PO

Administered by: Private       Purchased by: Other
Symptoms: Asphyxia, Hypoxia, Injury
SMQs:, Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Accidents and injuries (narrow), Hostility/aggression (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1999-01-05
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: UNK~ ()~~~In patient
Other Medications: NONE
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC Split Type:

Write-up: Pt recv vax on 12/24/98; on 1/5/99 pt expired


VAERS ID: 118638 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Male  
Location: California  
Vaccinated:1999-01-04
Onset:1999-01-05
   Days after vaccination:1
Submitted: 1999-01-13
   Days after onset:8
Entered: 1999-02-09
   Days after submission:27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 0970140 / 1 RL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0433H / 2 RL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 1102H / 1 LL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. N0652 / 1 LA / SC

Administered by: Private       Purchased by: Private
Symptoms: Interstitial lung disease, Unevaluable event
SMQs:, Interstitial lung disease (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1999-01-05
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: pt recv vax 4JAN99 & suffered crib death 5JAN99;


VAERS ID: 118656 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Male  
Location: Oklahoma  
Vaccinated:1998-09-23
Onset:1998-10-04
   Days after vaccination:11
Submitted: 1999-01-26
   Days after onset:114
Entered: 1999-02-09
   Days after submission:14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (ACEL-IMUNE) / PFIZER/WYETH 455840 / 1 RL / IM
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 2703A9 / 2 RL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH 361503A / 1 LL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. N0562 / 1 LL / IM

Administered by: Private       Purchased by: Private
Symptoms: Convulsion, Hypokinesia, Mental retardation severity unspecified, Neuropathy
SMQs:, Peripheral neuropathy (narrow), Systemic lupus erythematosus (broad), Convulsions (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Zantac;Reglan;recv hep b #1 at age 2 days;
Current Illness: NONE
Preexisting Conditions: cleft palate, GE reflux, apnea, poor suck & coordination p/ birth, Had some central obstructive apneac episodes beginning at 2-3 wk p/ birth.
Allergies:
Diagnostic Lab Data: EEG x 2 normal, EEG JAN99 abn;MRI brain normal JAN99
CDC Split Type:

Write-up: pt recv vax & began crying & cyanotic spells;admitted for evaluated wk later & felt to be sz episode; Now pt very delayed w/ minimal purposeful movement & continued seizure activity. Annual follow up dated 9/27/00 states that the pt was transferred to another facility. He developed sepsis from S. pneumonia and died a few hours later. 9 months of age at death.


VAERS ID: 118836 (history)  
Form: Version 1.0  
Age: 0.3  
Sex: Male  
Location: Illinois  
Vaccinated:1999-01-20
Onset:1999-01-22
   Days after vaccination:2
Submitted: 1999-01-28
   Days after onset:6
Entered: 1999-02-10
   Days after submission:13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 0929690 / 1 LL / IM
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 1363H / 1 RL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. N0652 / 1 RA / SC

Administered by: Public       Purchased by: Public
Symptoms: Apnoea, Bronchitis, Infection, Pulmonary oedema
SMQs:, Cardiac failure (narrow), Acute central respiratory depression (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Respiratory failure (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1999-01-22
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC Split Type: IL99005

Write-up: according to the case worker child was seen 4:30 21JAN99-child was happy, playful;no signs of child not feeling well;child was found by foster parents @ 12:45PM in crib not breathing;autopsy was performed-results are pending;


VAERS ID: 119005 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Male  
Location: Iowa  
Vaccinated:1999-02-04
Onset:1999-02-06
   Days after vaccination:2
Submitted: 1999-02-09
   Days after onset:3
Entered: 1999-02-16
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPHIB: DTP + HIB (TETRAMUNE) / PFIZER/WYETH 454342 / 1 RL / IM
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 2713A2 / 1 LL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. N0147 / 1 RL / SC

Administered by: Other       Purchased by: Public
Symptoms: Sudden infant death syndrome
SMQs:, Neonatal disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1999-02-06
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: APAP PRN
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: autopsy results pending;
CDC Split Type: IA99004

Write-up: pt brought to ER w/apparent SIDS;found in crib by caregiver;


VAERS ID: 119055 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Male  
Location: Massachusetts  
Vaccinated:1999-02-01
Onset:1999-02-04
   Days after vaccination:3
Submitted: 1999-02-11
   Days after onset:7
Entered: 1999-02-17
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 0942540 / 1 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH 361503A / 1 RL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. N0491 / 1 RL / SC

Administered by: Private       Purchased by: Public
Symptoms: Pneumonia, Sepsis, Sudden infant death syndrome
SMQs:, Eosinophilic pneumonia (broad), Neonatal disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Sepsis (narrow), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1999-02-04
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: autopsy pending;
CDC Split Type:

Write-up: SIDS event 72hr p/vax;


VAERS ID: 119205 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Female  
Location: Michigan  
Vaccinated:1998-09-22
Onset:1998-09-28
   Days after vaccination:6
Submitted: 1999-01-26
   Days after onset:120
Entered: 1999-02-22
   Days after submission:27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (ACEL-IMUNE) / PFIZER/WYETH 455841 / 1 LL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0939E / 2 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH 360753A / 1 RL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. N0212 / 1 RL / SC

Administered by: Public       Purchased by: Public
Symptoms: Agitation, Anorexia, Sudden infant death syndrome
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Neonatal disorders (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1998-09-29
   Days after onset: 1
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC Split Type: MI99011

Write-up: mom stated that week before death there was no apparent fever-only some fussiness & lack of appetite, formula intake from 7oz to 3-4oz per feeding;


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