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Found 144 cases where Vaccine is RV1 and Patient Died

Table

   
AgeCountPercent
< 3 Years13190.97%
Unknown139.03%
TOTAL144100%

Case Details

This is page 1 out of 15

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VAERS ID:344816 (history)  Vaccinated:2009-04-16
Age:0.2  Onset:2009-04-21, Days after vaccination: 5
Gender:Male  Submitted:2009-04-21, Days after onset: 0
Location:Arkansas  Entered:2009-04-24, Days after submission: 3
Life Threatening? No
Died? Yes
   Date died: 2009-04-21
   Days after onset: 0
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type: AR0912
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL)SANOFI PASTEURC3279AA0IMRL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0062X1IMLL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHD243220IMLL
RV1: ROTAVIRUS (ROTARIX)GLAXOSMITHKLINE BIOLOGICALSA41CA693A0PO 
Administered by: Public     Purchased by: Unknown
Symptoms: Death, Sudden infant death syndrome
SMQs:, Neonatal disorders (narrow)
Write-up: None stated. 6/22/09 Autopsy report received DOS 4/22/09. Cause of Death: Sudden Infant Death Syndrome (SIDS). Manner of Death: Natural.

VAERS ID:352162 (history)  Vaccinated:2009-07-17
Age:0.21  Onset:2009-07-22, Days after vaccination: 5
Gender:Female  Submitted:2009-07-22, Days after onset: 0
Location:Nevada  Entered:2009-07-22
Life Threatening? No
Died? Yes
   Date died: 2009-07-22
   Days after onset: 0
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data: 7/23/09 Medical records and DC summary received. LABS and DIAGNOSTICS: CT Brain - Frontal hemorrhage. CBC - WBC 2.28 (L) HGB 14.5 (H) HCT 40.3 (H) MCV 88 (H) MCHC 36.2 (H) PLT 76 (L) MONO 2.6% (L) EOS 0.0% (L) NEUT# 0.89 (L) LYMPH# 1.30 (L) MONO# 0.06 (L) EOS# 0.00 (L). Coagulation - Protime 15.7 (H) INR 1.7 (H) PTT 140 (H) D-DIMER 35.20 (H). CHEM - CL 124 (H) Glucose 255 (H) Total Protein 4.5 (L) Albumin 3.2 (L) A/G ratio 2.5 (H) Calcium 7.7 (L) SGOT/AST 162 (H) SGPT/ALT 319 (H) Total Alk Phos 579 (H) Total CK 688 (H) Lactate 9.7 (H). Urine Tox Screen - Benzodiazapines. Urinalysis - color red, cloudy, glucose 100, blood large amt, protein 100, bacteria trace. Urine culture - E. Coli. Tracheal culture - Strep agalactiae, Staph aureus. Blood
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B201BA0IMRL
HIBV: HIB (ACTHIB)SANOFI PASTEURUF608AA0IMLL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHD361470IMLL
RV1: ROTAVIRUS (ROTARIX)GLAXOSMITHKLINE BIOLOGICALSA41CA692A0PO 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Death
SMQs:
Write-up: The baby died under suspicious conditions this morning. 7/23/09 Medical records and DC summary received. Assessment: Multisystem organ failure, severe traumatic brain injury, acute respiratory distress syndrome, metabolic acidosis, rule out nonaccidental trauma. Patient presents with frontal traumatic brain injury, bilateral pneumothoraces, decreased hemoglobin and hematocrit. Pupils are 4 mm and fixed. Does not move face or extremities. GCS of 6T. Bruising to frontal scalp area, left knee. No corneal (reflex) no gag (reflex), no movement to pain. Diffuse hypotonia. Preretinal hemorrhage. Corneal edema. Anoxic encephalopathy. Depressed brain stem reflexes.

VAERS ID:353311 (history)  Vaccinated:2009-08-05
Age:0.15  Onset:0000-00-00
Gender:Male  Submitted:2009-08-06
Location:Colorado  Entered:2009-08-06
Life Threatening? No
Died? Yes
   Date died: 2009-08-06
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: N/A
Preexisting Conditions: N/A
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL)SANOFI PASTEURC3277AA0IMLL
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBV663AA1IMRL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHD243220IMRL
RV1: ROTAVIRUS (ROTARIX)GLAXOSMITHKLINE BIOLOGICALSA41DA692A0PO 
Administered by: Unknown     Purchased by: Unknown
Symptoms:
SMQs:
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.

VAERS ID:353395 (history)  Vaccinated:2009-07-15
Age:0.33  Onset:2009-07-19, Days after vaccination: 4
Gender:Male  Submitted:2009-08-07, Days after onset: 19
Location:Unknown  Entered:2009-08-07
Life Threatening? No
Died? Yes
   Date died: 2009-07-19
   Days after onset: 0
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: 10/5/09 Medical records received w/PMH: left clavicle fx at birth.
Diagnostic Lab Data: UNK
CDC Split Type: A0800503A
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B173AA IMUN
HIBV: HIB (ACTHIB)SANOFI PASTEURUF569AA IMLL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHD37015 IMRL
RV1: ROTAVIRUS (ROTARIX)GLAXOSMITHKLINE BIOLOGICALSA41FA782A PO 
Administered by: Other     Purchased by: Other
Symptoms: Cardio-respiratory arrest, Cyanosis, Death, Immediate post-injection reaction, Muscle rigidity, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Parkinson-like events (narrow), Acute central respiratory depression (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Respiratory failure (broad)
Write-up: This case was reported by a healthcare professional, via a GSK representative and described the occurrence of death nos in a 4-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). Concurrent vaccination included Haemophilus influenza type b vaccine (non-gsk) (non-GSK manufacturer) given on 15 July 2009; PEDIARIX (GlaxoSmithKline) given on 15 July 2009; PREVNAR (non-gsk) (non-GSK manufacturer) given on 15 July 2009. On 15 July 2009 the subject received unspecified dose of ROTARIX (details unknown). On 19 July 2009, 4 days after vaccination with ROTARIX, the subject experienced death nos. The healthcare professional considered the event was possibly related to vaccination with ROTARIX. The subject died on 19 July 2009; cause of death was not specified. It was unknown whether an autopsy was performed. No further details were reported. 8/13/09 Received PCP medical records of 3/24/09- Records reveal patient seen in office on 7/7/09 for wet cough, nasal congestion, rhinitis, eating difficulty. Dx viral URI. Sick family member. RTC 7/9/09 w/vomiting, cough, decreased appetite x 3 days. Dx viral gastroenteritis. RTC 7/15, well child visit w/shots. Immediately after shots had emesis x 1 then perioral cyanosis w/recovery in 5 min. ER records of 7/18/09 included which reveal patient arrived in full arrest approx 9 hr after being put to bed w/Tylenol, in asystole & unable to intubate due to rigor. 10/5/09 ER records received for 7/18/09 which had been previously received.

VAERS ID:360138 (history)  Vaccinated:2009-09-02
Age:0.27  Onset:2009-09-03, Days after vaccination: 1
Gender:Male  Submitted:0000-00-00
Location:Kentucky  Entered:2009-10-08
Life Threatening? No
Died? Yes
   Date died: 2009-10-05
   Days after onset: 32
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, 32 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None Known
Preexisting Conditions: Inguinal Hernia.
Diagnostic Lab Data: CBCw Diff; CMP; ABG; Urinalysis; HSV, Negative; PCS, negative; CT; Brain MRI; EEG, left temporal focus
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B208AA UNRL
HIBV: HIB (ACTHIB)SANOFI PASTEURUF596AB UNLL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHD74257 UNLL
RV1: ROTAVIRUS (ROTARIX)GLAXOSMITHKLINE BIOLOGICALSA41FA732A UNUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Abdominal X-ray, Abdominal compartment syndrome, Activated partial thromboplastin time prolonged, Alanine aminotransferase increased, Anoxic encephalopathy, Aspartate aminotransferase increased, Blood calcium decreased, Blood chloride increased, Blood creatinine increased, Blood fibrinogen increased, Blood gases, Blood glucose increased, Blood magnesium increased, Blood phosphorus increased, Blood sodium increased, Blood urea increased, Brain injury, Bronchopneumonia, C-reactive protein increased, CSF glucose increased, CSF protein increased, CSF test abnormal, CSF white blood cell differential, Chest X-ray abnormal, Citrobacter infection, Computerised tomogram, Computerised tomogram abnormal, Convulsion, Cytogenetic analysis abnormal, Death, Differential white blood cell count, Drug level decreased, Dyskinesia, Dyspnoea, Electroencephalogram abnormal, Epilepsy, Fibrin D dimer increased, Fontanelle depressed, Full blood count, Gliosis, Haematocrit decreased, Herpes simplex serology negative, Hiccups, Hypotension, Hypotonia, Ileus, Intensive care, International normalised ratio increased, Lymphocyte percentage decreased, Mean platelet volume increased, Mechanical ventilation, Metabolic acidosis, Metabolic function test, Neutrophil percentage increased, Nuclear magnetic resonance imaging brain, Nuclear magnetic resonance imaging brain abnormal, Peritonitis, Prothrombin time prolonged, Pulse abnormal, Rash, Rash erythematous, Respiratory failure, Staphylococcal infection, Status epilepticus, Tachycardia, Thyroxine free decreased, Tracheitis, Urinary bladder haemorrhage, Urinary tract infection, Urine analysis, White blood cell count increased, X-ray abnormal
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Liver related investigations, signs and symptoms (narrow), Liver-related coagulation and bleeding disturbances (narrow), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Haematopoietic erythropenia (broad), Haematopoietic leukopenia (broad), Lack of efficacy/effect (narrow), Lactic acidosis (broad), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Ischaemic central nervous system vascular conditions (narrow), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Convulsions (narrow), Dyskinesia (narrow), Gastrointestinal obstruction (narrow), Gastrointestinal perforation (narrow), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypothyroidism (broad), Hyperthyroidism (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Neonatal disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Chronic kidney disease (broad), Hypersensitivity (narrow), Tumour lysis syndrome (narrow), Tubulointerstitial diseases (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: 3 mo old infant received multiple vaccines to include PEDIARIX, HIB, PREVNAR, and ROTARIX during well child visit on September 2nd. On September 3rd. he was brought to Pediatric Clinic by his mother with c/o "trouble breathing". When the physician came into the room, the infant was noted to be seizing. A CBC, CMP, ABG and urine samples were also collected. He was diagnosed with Status Epilepticus and taken to a Hospital where he was admitted to PICU. A CT and brain MRI were completed. EEG demonstrated left temporal focus; HSV PCS & culture were negative; the initial infant screen was insufficient, repeat infant screen, ID & genetic consults are pending.

VAERS ID:365428 (history)  Vaccinated:2008-10-16
Age:0.34  Onset:2008-11-05, Days after vaccination: 20
Gender:Male  Submitted:2009-11-05, Days after onset: 365
Location:Montana  Entered:2009-11-05
Life Threatening? No
Died? Yes
   Date died: 2008-11-05
   Days after onset: 0
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Patient was on Amoxicillan since birth due to slight hydronephrosis in his left kidney
Current Illness: None, the week prior he had a viral outbreak of sores in his mouth/ throat, physician thought he would be fine to vaccinate th
Preexisting Conditions: He had hydronephrosis in his left kidney, was on amoxicillan for it
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B153BA1IMRL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHD058810IMRL
RV1: ROTAVIRUS (ROTARIX)GLAXOSMITHKLINE BIOLOGICALSA41FA681A1PO 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Choking, Death, Irritability, Respiratory tract inflammation, Sudden infant death syndrome
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Neonatal disorders (narrow), Hypersensitivity (broad), Hypoglycaemia (broad)
Write-up: Patient was fussy on 11/04/2009, he was hard to calm down in the morning at approx 4 am I awoke to sounds of him choking, I picked him up and then he was fine, I took him to daycare that morning and received the phone call at 4:30 pm that he was being rushed to the ER. 12/22/09 Death Certificate Received, DOD 11/05/08, Cause of Death: Sudden Infant Death Syndrome (SIDS) at daycare. 12/22/09 Autopsy received. Cause of Death: Sudden Infant Death Syndrome (SIDS). Additional information abstracted: Had been fussy and more congested lately. Chronic inflammation in the large airways likely due to viral infection.

VAERS ID:379119 (history)  Vaccinated:2010-01-13
Age:0.17  Onset:2010-01-30, Days after vaccination: 17
Gender:Male  Submitted:2010-02-02, Days after onset: 3
Location:Florida  Entered:2010-02-02
Life Threatening? No
Died? Yes
   Date died: 2010-01-30
   Days after onset: 0
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Thrush
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL)SANOFI PASTEURC3261AA0UNLL
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBHB730AA UNRL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHD489280UNRL
RV1: ROTAVIRUS (ROTARIX)GLAXOSMITHKLINE BIOLOGICALSA41DA802A0PO 
Administered by: Private     Purchased by: Public
Symptoms: Death
SMQs:
Write-up: None stated.

VAERS ID:379398 (history)  Vaccinated:2009-12-30
Age:0.34  Onset:0000-00-00
Gender:Male  Submitted:2010-01-27
Location:Iowa  Entered:2010-02-04, Days after submission: 8
Life Threatening? No
Died? Yes
   Date died: 2010-01-16
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Ear infection
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL)SANOFI PASTEURC3565AB1IMLL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHE064271IMRL
RV1: ROTAVIRUS (ROTARIX)GLAXOSMITHKLINE BIOLOGICALSA41FA963A1PO 
Administered by: Private     Purchased by: Private
Symptoms: Death
SMQs:
Write-up: None stated.

VAERS ID:381218 (history)  Vaccinated:2010-02-17
Age:0.46  Onset:2010-02-19, Days after vaccination: 2
Gender:Male  Submitted:2010-02-22, Days after onset: 3
Location:Arkansas  Entered:2010-02-24, Days after submission: 2
Life Threatening? No
Died? Yes
   Date died: 2010-02-19
   Days after onset: 0
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: AR1004
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL)SANOFI PASTEURC3554AA1IMLL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHD944331IMRL
RV1: ROTAVIRUS (ROTARIX)GLAXOSMITHKLINE BIOLOGICALSA41CA8171PO 
Administered by: Public     Purchased by: Public
Symptoms: Death
SMQs:
Write-up: 2-19-2010 Notified by coroner that child had died today requesting copy of immunization record. No other information available.

VAERS ID:384071 (history)  Vaccinated:2010-02-17
Age:0.36  Onset:2010-02-17, Days after vaccination: 0
Gender:Male  Submitted:2010-04-02, Days after onset: 43
Location:Indiana  Entered:2010-04-02
Life Threatening? No
Died? Yes
   Date died: 2010-02-17
   Days after onset: 0
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data: Autopsy
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL)SANOFI PASTEUR3542AA1IMLL
PNC: PNEUMO (PREVNAR)PFIZER/WYETH881831IMRL
RV1: ROTAVIRUS (ROTARIX)GLAXOSMITHKLINE BIOLOGICALSA41CB036A1PO 
Administered by: Public     Purchased by: Public
Symptoms: Autopsy, Death, Respiratory arrest
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Respiratory failure (narrow)
Write-up: No symptons,or signs prior to child not breathing. Child taken to ER and CPR was implemented.

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