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

This is VAERS ID 307550

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Case Details

VAERS ID: 307550 (history)  
Form: Version 1.0  
Age: 0.3  
Sex: Female  
Location: Foreign  
Vaccinated:2008-03-15
Onset:2008-03-15
   Days after vaccination:0
Submitted: 2008-03-20
   Days after onset:5
Entered: 2008-03-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPHEP: DTP + HEP B (TRITANRIX) / GLAXOSMITHKLINE BIOLOGICALS AT15B371AF / 2 UN / IM
RVX: ROTAVIRUS (NO BRAND NAME) / UNKNOWN MANUFACTURER A41CA414A / 2 MO / PO

Administered by: Other       Purchased by: Other
Symptoms: Diarrhoea, Pyrexia, Sudden infant death syndrome
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Neonatal disorders (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2008-03-16
   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: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC Split Type: B0512476B

Write-up: This case was reported by a physician and described the occurrence of sudden infant death syndrome in a 4-month-old female subject who was vaccinated with ROTARIX, GlaxoSmithKline, combined TRITANRIX HEP B for prophylaxis. The baby had no history of any disease or any medication. She had no history of allergy. Previous vaccination included TRITANRIX HEP B (GlaxoSmithKline; intramuscular; unknown) and ROTARIX (GlaxoSmithKline; oral) given at the age of 2 months. At previous vaccination with ROTARIX AND TRITANRIX HEP B the subject developed low fever and few episodes of diarrhea (for details see case B0512476A). On 15 March 2008, the subject received the 2nd dose of ROTARIX (oral), the 2nd dose of TRITANRIX HEP B (intramuscular, unknown). On 15 March 2008 (at the night time), less than one day after vaccination with the 2nd dose of ROTARIX and the 2nd dose of TRITANRIX HEP B, the subject experienced an episode of diarrhea and low fever. No other abnormal symptoms. On 16 March 2008 morning, after sleeping for 4 hours the parents found that their baby was dead. The subject died on 16 March 2008 from sudden infant death syndrome. On 17 March 2008, the doctor asked the baby''s parents for the autopsy but there was still no answer from the parents. Follow up information received on 18 March 2008: Autopsy was not done, the family refused and funeral will be finished on 19 March 2008.


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