National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts.org
Search Results

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

This is VAERS ID 266239

Government Disclaimer on use of this data



Case Details

VAERS ID: 266239 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Male  
Location: California  
Vaccinated:2006-10-17
Onset:0000-00-00
Submitted: 2006-11-07
Entered: 2006-11-08
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B065AA / 1 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UE009AB / 1 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08653R / 1 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0776F / 1 MO / PO

Administered by: Other       Purchased by: Other
Symptoms: Diarrhoea, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2006-10-23
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: Birth HX: Birth: 8 lbs, 12 oz, ht 21, head circ 16. Noted to have a rash on initial exam. Dx Infant dermatitis & treated. OB/GYN of mother records from pcp reveals Mom was 23yo, g4, p2 with PMH of gonorrhea & chlamydia, HSV I & II, Grp B strep.
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: On call doctor was called on 10/23/06 that the pt was brought to ER (hospital) and pt was dead already. History of diarrhea and vomiting. 11/14/06 Received medical records from PCP including med record from OB/GYN of mother which reveals Mom was 23yo, g4, p2 with PMH of gonorrhea & chlamydia, HSV I & II, Grp B strep. Developed thrush on 8/25/06 visit & treated. On 10/17 date of vax visit weight was 12 lbs 9 oz, length 23, head 15.5. Child was noted to be healthy at that time. 6/12/07 Received autopsy report which reveals COD as dehydration due to gastroenteritis & manner of death as natural. Dehydration from severe diarrhea was contributing factor. Parent reported patient had been vomiting along w/diarrhea since 10/21 (received vaccines on 10/17). Parent also admitted to use of drugs (crank) up until her 5th month of pregnancy when prenatal care began. Parent reported that allergy to formula may have been contributory as patient was on his 3rd type of formula. Coroner investigation reveals no milk allergy was reported in pcp medical records.


New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=266239


Copyright © 2022 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166