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

This is VAERS ID 265462

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Case Details

VAERS ID: 265462 (history)  
Form: Version 1.0  
Age: 0.13  
Sex: Female  
Location: Washington  
Vaccinated:2006-10-02
Onset:2006-10-02
   Days after vaccination:0
Submitted: 2006-10-19
   Days after onset:17
Entered: 2006-10-27
   Days after submission:8
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -
HEP: HEP B (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 - / -
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH - / 1 - / -
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / 1 MO / PO

Administered by: Private       Purchased by: Other
Symptoms: Coma, Fatigue, Irritability
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2006-10-04
   Days after onset: 2
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:
Preexisting Conditions: Born premature 3 weeks 1 day early and low birth weight.
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: After administering vaccines child became very fussy and over tired, would not wake to eat and passed away a little over a day later. Autopsy could not say that vaccines did not play role in death.


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