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

This is VAERS ID 353311

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Case Details

VAERS ID: 353311 (history)  
Form: Version 1.0  
Age: 0.15  
Sex: Male  
Location: Colorado  
Vaccinated:2009-08-05
Onset:0000-00-00
Submitted: 2009-08-06
Entered: 2009-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3277AA / 1 LL / IM
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBV663AA / 2 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH D24322 / 1 RL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41DA692A / 1 MO / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms:
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2009-08-06
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: N/A
Preexisting Conditions: N/A
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: none, 9/25/09 Autopsy report received - Cause of Death - Probable Partial Mechanical Obstruction of Airway by Ectopic Thymus. By history baby developed "noisy breathing" by evening. Found prone and unresponsive. Only explanation for abnormal breathing sounds was a benign growth, an extra thymus gland, growing in the wrong place next to his trachea.


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