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This is VAERS ID 450453

History of Changes from the VAERS Wayback Machine

First Appeared on 3/12/2012

VAERS ID: 450453
VAERS Form:
Age:1.1
Sex:Male
Location:Maine
Vaccinated:2012-02-07
Onset:2012-02-08
Submitted:2012-02-22
Entered:2012-02-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C4003AA / 3 RL / IM
FLU: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR UT4149CA / 0 RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0852AA / 0 LL / SC
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F17155 / 0 LL / IM

Administered by: Public      Purchased by: Public
Symptoms: Death, Unresponsive to stimuli

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-02-08
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None known
Preexisting Conditions: None known
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient found unresponsive by babysitter. EMS called to scene. Patient transported to ER at Medical Center. Time of death noted to be 20:48 on 2/8/12 by ER.


Changed on 7/7/2013

VAERS ID: 450453 Before After
VAERS Form:
Age:1.1
Sex:Male
Location:Maine
Vaccinated:2012-02-07
Onset:2012-02-08
Submitted:2012-02-22
Entered:2012-02-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C4003AA / 3 RL / IM
FLU: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR UT4149CA / 0 RL / IM
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR UT4149CA / 0 RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0852AA / 0 LL / SC
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F17155 / 0 LL / IM

Administered by: Public      Purchased by: Public
Symptoms: Death, Unresponsive to stimuli

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-02-08
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None known
Preexisting Conditions: None known
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient found unresponsive by babysitter. EMS called to scene. Patient transported to ER at Medical Center. Time of death noted to be 20:48 on 2/8/12 by ER.


Changed on 6/14/2014

VAERS ID: 450453 Before After
VAERS Form:
Age:1.1
Sex:Male
Location:Maine
Vaccinated:2012-02-07
Onset:2012-02-08
Submitted:2012-02-22
Entered:2012-02-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C4003AA / 3 RL / IM
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR UT4149CA / 0 RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0852AA / 0 LL / SC
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F17155 / 0 LL / IM

Administered by: Public      Purchased by: Public
Symptoms: Death, Unresponsive to stimuli

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-02-08
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None known
Preexisting Conditions: None known
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient found unresponsive by babysitter. EMS called to scene. Patient transported to ER at Medical Center. Time of death noted to be 20:48 on 2/8/12 by ER.


Changed on 3/14/2015

VAERS ID: 450453 Before After
VAERS Form:
Age:1.1
Sex:Male
Location:Maine
Vaccinated:2012-02-07
Onset:2012-02-08
Submitted:2012-02-22
Entered:2012-02-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C4003AA / 3 RL / IM
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR UT4149CA / 0 RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0852AA / 0 LL / SC
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F17155 / 0 LL / IM

Administered by: Public      Purchased by: Public
Symptoms: Death, Unresponsive to stimuli

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-02-08
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None known
Preexisting Conditions: None known
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient found unresponsive by babysitter. EMS called to scene. Patient transported to ER at Medical Center. Time of death noted to be 20:48 on 2/8/12 by ER.


Changed on 2/14/2017

VAERS ID: 450453 Before After
VAERS Form:
Age:1.1 1.07
Sex:Male
Location:Maine
Vaccinated:2012-02-07
Onset:2012-02-08
Submitted:2012-02-22
Entered:2012-02-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C4003AA / 3 RL / IM
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR UT4149CA / 0 RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0852AA / 0 LL / SC
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F17155 / 0 LL / IM

Administered by: Public      Purchased by: Public
Symptoms: Death, Unresponsive to stimuli

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-02-08
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None known
Preexisting Conditions: None known
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient found unresponsive by babysitter. EMS called to scene. Patient transported to ER at Medical Center. Time of death noted to be 20:48 on 2/8/12 by ER.


Changed on 9/14/2017

VAERS ID: 450453 Before After
VAERS Form:(blank) 1
Age:1.07
Sex:Male
Location:Maine
Vaccinated:2012-02-07
Onset:2012-02-08
Submitted:2012-02-22
Entered:2012-02-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C4003AA / 3 4 RL / IM
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR UT4149CA / 0 1 RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0852AA / 0 1 LL / SC
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F17155 / 0 1 LL / IM

Administered by: Public      Purchased by: Public
Symptoms: Death, Unresponsive to stimuli

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-02-08
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None known
Preexisting Conditions: None known
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient found unresponsive by babysitter. EMS called to scene. Patient transported to ER at Medical Center. Time of death noted to be 20:48 on 2/8/12 by ER.


Changed on 2/14/2018

VAERS ID: 450453 Before After
VAERS Form:1
Age:1.07
Sex:Male
Location:Maine
Vaccinated:2012-02-07
Onset:2012-02-08
Submitted:2012-02-22
Entered:2012-02-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C4003AA / 4 RL / IM
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR UT4149CA / 1 RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0852AA / 1 LL / SC
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F17155 / 1 LL / IM

Administered by: Public      Purchased by: Public
Symptoms: Death, Unresponsive to stimuli

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-02-08
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None known
Preexisting Conditions: None known
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient found unresponsive by babysitter. EMS called to scene. Patient transported to ER at Medical Center. Time of death noted to be 20:48 on 2/8/12 by ER.


Changed on 6/14/2018

VAERS ID: 450453 Before After
VAERS Form:1
Age:1.07
Sex:Male
Location:Maine
Vaccinated:2012-02-07
Onset:2012-02-08
Submitted:2012-02-22
Entered:2012-02-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C4003AA / 4 RL / IM
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR UT4149CA / 1 RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0852AA / 1 LL / SC
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F17155 / 1 LL / IM

Administered by: Public      Purchased by: Public
Symptoms: Death, Unresponsive to stimuli

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-02-08
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None known
Preexisting Conditions: None known
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient found unresponsive by babysitter. EMS called to scene. Patient transported to ER at Medical Center. Time of death noted to be 20:48 on 2/8/12 by ER.


Changed on 8/14/2018

VAERS ID: 450453 Before After
VAERS Form:1
Age:1.07
Sex:Male
Location:Maine
Vaccinated:2012-02-07
Onset:2012-02-08
Submitted:2012-02-22
Entered:2012-02-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C4003AA / 4 RL / IM
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR UT4149CA / 1 RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0852AA / 1 LL / SC
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F17155 / 1 LL / IM

Administered by: Public      Purchased by: Public
Symptoms: Death, Unresponsive to stimuli

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-02-08
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None known
Preexisting Conditions: None known
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient found unresponsive by babysitter. EMS called to scene. Patient transported to ER at Medical Center. Time of death noted to be 20:48 on 2/8/12 by ER.


Changed on 9/14/2018

VAERS ID: 450453 Before After
VAERS Form:1
Age:1.07
Sex:Male
Location:Maine
Vaccinated:2012-02-07
Onset:2012-02-08
Submitted:2012-02-22
Entered:2012-02-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C4003AA / 4 RL / IM
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR UT4149CA / 1 RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0852AA / 1 LL / SC
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F17155 / 1 LL / IM

Administered by: Public      Purchased by: Public
Symptoms: Death, Unresponsive to stimuli

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-02-08
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None known
Preexisting Conditions: None known
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient found unresponsive by babysitter. EMS called to scene. Patient transported to ER at Medical Center. Time of death noted to be 20:48 on 2/8/12 by ER.


Changed on 10/14/2018

VAERS ID: 450453 Before After
VAERS Form:1
Age:1.07
Sex:Male
Location:Maine
Vaccinated:2012-02-07
Onset:2012-02-08
Submitted:2012-02-22
Entered:2012-02-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C4003AA / 4 RL / IM
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR UT4149CA / 1 RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0852AA / 1 LL / SC
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F17155 / 1 LL / IM

Administered by: Public      Purchased by: Public
Symptoms: Death, Unresponsive to stimuli

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-02-08
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None known
Preexisting Conditions: None known
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient found unresponsive by babysitter. EMS called to scene. Patient transported to ER at Medical Center. Time of death noted to be 20:48 on 2/8/12 by ER.

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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=450453&WAYBACKHISTORY=ON


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