VAERS ID: 25014

AGE: 0.4| SEX: U|STATE: SC (United States)

Description

4 month old infant received 2nd immunization & became very irritable, fussy & refused to eat. w/ 1st imminization, infant was fussy for about 3 days.

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Symptoms

Agitation, Anorexia

Vaccines

VAX DATE: | ONSET DATE: | DAYS TO ONSET:
NameDose #TypeManufacturerLotRouteSite
DTP (TRI-IMMUNOL) 2 DTP LEDERLE LABORATORIES 259965

RECVDATE:07-02-1990
RPT_DATE:
CAGE_YR:
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:Y
LAB_DATA:
V_ADMINBY:PVT
OTHER_MEDS:
CUR_ILL:
HISTORY:
PRIOR_VAX:~ ()~~~In patient
SPLTTYPE:8902804.01
FORM_VERS:
TODAYS_DATE:
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:
V_FUNDBY:

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