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

This is VAERS ID 679107

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Case Details

VAERS ID: 679107 (history)  
Form: Version 1.0  
Age: 0.33  
Sex: Male  
Location: Wisconsin  
Vaccinated:2016-03-03
Onset:2016-03-04
   Days after vaccination:1
Submitted: 2017-01-23
   Days after onset:325
Entered: 2017-01-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 LL / IM
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH - / 2 RL / IM
RVX: ROTAVIRUS (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 MO / PO

Administered by: Unknown       Purchased by: Other
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2016-03-07
   Days after onset: 3
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NO
Preexisting Conditions: NO
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: My son was put down for a nap about 12 or a bit after and he never woke up.


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