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

This is VAERS ID 105295

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Case Details

VAERS ID: 105295 (history)  
Form: Version 1.0  
Age: 0.3  
Sex: Female  
Location: North Carolina  
Vaccinated:1997-11-12
Onset:1997-11-14
   Days after vaccination:2
Submitted: 1997-11-24
   Days after onset:10
Entered: 1997-12-02
   Days after submission:8
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 7L81673 / 2 RL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M165RH / 2 RL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. M0443 / 2 LL / IM

Administered by: Private       Purchased by: Public
Symptoms: Asphyxia, Stupor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Respiratory failure (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1997-11-14
   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 results pending
CDC Split Type:

Write-up: pt found unresponsive sleeping w/mom on couch @ home;DOA


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