VAERS ID: 26241

AGE: 2| SEX: F|STATE: WI (United States)

Description

Pt vaccinated with DTP then death occurred 3/90. Cause of death listed as reaction to DTP vaccination.

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Symptoms

Delirium, Convulsion, Neuropathy, Cerebrovascular disorder, Pneumonia, CSF test abnormal, Encephalopathy, Hepatic necrosis

Vaccines

VAX DATE: 06-20-1989| ONSET DATE: 06-23-1989| DAYS TO ONSET: 3
NameDose #TypeManufacturerLotRouteSite
DTP (TRI-IMMUNOL) 4 DTP LEDERLE LABORATORIES 232968 Unknown Unknown

RECVDATE:10-12-1990
RPT_DATE:
CAGE_YR:1
CAGE_MO:1
DIED:Y
DATEDIED:03-28-1990
L_THREAT:U
ER_VISIT:
HOSPITAL:Y
HOSPDAYS:60
X_STAY:U
DISABLE:U
RECOVD:N
LAB_DATA:
V_ADMINBY:
OTHER_MEDS:
CUR_ILL:
HISTORY:
PRIOR_VAX:~ ()~~~In patient
SPLTTYPE:9001578.01
FORM_VERS:
TODAYS_DATE:
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:
V_FUNDBY:

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