National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts.org
Search Results

From the 7/12/2011 release of VAERS data (an older release, current is 1/7/2022):

This is VAERS ID 424958

Government Disclaimer on use of this data



Case Details

VAERS ID: 424958 (history)  
Form: Version .0  
Age: 0.2  
Sex: Male  
Location: New Hampshire  
Vaccinated:2011-05-01
Onset:2011-05-31
   Days after vaccination:30
Submitted: 2011-06-07
   Days after onset:7
Entered: 2011-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3792AA / 1 UN / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0979Z / 2 - / -
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH E63642 / 1 UN / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0205AA / 1 - / PO

Administered by: Private       Purchased by: Public
Symptoms: Death, Premature baby
SMQs:, Neonatal disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2011-05-31
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: NH06071104

Write-up: Baby was immunized 4/6/11. Baby was born prematurely. Hep B refused.


New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20110712&IDNUMBER=424958


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