VAERS ID: 25003

AGE: 0.8| SEX: M|STATE: TX

Description

Hypotonic, Hyporesponsive episode, Infant died: Reyes text Syndrome. Vaccine given for routine immunizations.

Symptoms

Delirium, Hypokinesia, Hypotonia

Vaccines

VAX DATE: 01-29-1990| ONSET DATE: 02-04-1990| DAYS TO ONSET: 6
NameDose #TypeManufacturerLotRouteSite
DTP (TRI-IMMUNOL) 4 DTP LEDERLE LABORATORIES 259962 IM Unknown
POLIO VIRUS, ORAL (ORIMUNE) 4 OPV PFIZER\WYETH 241950 PO MO

RECVDATE:07-02-1990
RPT_DATE:
CAGE_YR:
CAGE_MO:
DIED:Y
DATEDIED:
L_THREAT:U
ER_VISIT:U
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:N
LAB_DATA:
V_ADMINBY:
OTHER_MEDS:
CUR_ILL:
HISTORY:
PRIOR_VAX:~ ()~~~In patient
SPLTTYPE:
FORM_VERS:1
TODAYS_DATE:
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:
V_FUNDBY:

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