VAERS ID: 26285

AGE: 0.4| SEX: M|STATE: GA (United States)

Description

CDC Reports: 5 mo infant received DTP/OPV on 19MAR90 and died 20AMR90. Patient was given Tylenol for a low grade fever 3 hrs before death.

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Symptoms

Pyrexia

Vaccines

VAX DATE: 03-19-1990| ONSET DATE: 03-20-1990| DAYS TO ONSET: 1
NameDose #TypeManufacturerLotRouteSite
DTP (TRI-IMMUNOL) 0 DTP LEDERLE LABORATORIES 256962
POLIO VIRUS, ORAL (ORIMUNE) 0 OPV PFIZER\WYETH 0599C PO MO

RECVDATE:10-19-1990
RPT_DATE:
CAGE_YR:0
CAGE_MO:0.4
DIED:Y
DATEDIED:03-20-1990
L_THREAT:U
ER_VISIT:
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:N
LAB_DATA:
V_ADMINBY:
OTHER_MEDS:
CUR_ILL:
HISTORY:
PRIOR_VAX:~ ()~~~In patient
SPLTTYPE:9001628.02
FORM_VERS:
TODAYS_DATE:
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:
V_FUNDBY:

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