Report #2838491

Received Apr 29, 2025

Died

A note on interpretation. VAERS reports are unverified and may be incomplete or coincidental. A report does not establish that a vaccine caused an event, and counts should not be used to calculate incidence or infer causation. Full disclaimer

Overview

Sex: Male
Age: 0.2 yrs
State: FL
Recovered: Not recovered
Vaccinated: Apr 15, 2025
Onset: Apr 17, 2025
Days to onset: 2
Hospital days: —

Vaccines (4)

Type	Name	Manufacturer	Dose	Lot	Route / Site
DTAPHEPBIP	DTAP + HEPB + IPV (PEDIARIX)	GLAXOSMITHKLINE BIOLOGICALS	1	2G273	IM / RL
HIBV	HIB (PEDVAXHIB)	MERCK & CO. INC.	1	Y013270	IM / RL
PNC20	PNEUMO (PREVNAR20)	PFIZER\WYETH	1	LK6653	IM / LL
RV1	ROTAVIRUS (ROTARIX)	GLAXOSMITHKLINE BIOLOGICALS	1	7E9Y2	PO / MO

Symptoms (4)

AutopsyDeathSudden infant death syndromeToxicologic test

Symptom narrative

04172025. Autopsy and toxicology pending. Presumed SIDS

Current illness

None

Medical history

Noxious Influence Via Placenta / Medicinal Agent affecting Newborn (ICD-10 P04.19)

Other medications

Mommys Bliss Vitamin D

Allergies

None

Lab data

Autopsy Pending District Medical Examiner's Office, (redacted), Investigator