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This is VAERS ID 477044

(NOTE: This result is from the 2/14/2018 version of the VAERS database)

Case Details

VAERS ID: 477044 (history)  
Form: Version 1.0  
Age: 0.17  
Sex: Male  
Location: Illinois  
Vaccinated:2012-11-29
Onset:2012-12-01
   Days after vaccination:2
Submitted: 2012-12-07
   Days after onset:6
Entered: 2012-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C4293AA / 1 RL / UN
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0384AE / 2 LL / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F95942 / 1 LL / UN

Administered by: Private       Purchased by: Private
Symptoms: Autopsy, Unresponsive to stimuli
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2012-12-01
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Coroners case - post inconclusive, other studies are pending
CDC Split Type:

Write-up: ER informed me 12-1-12 that child brought to ER after being found unresponsive in parent''s bed.


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20180214&IDNUMBER=477044


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