VAERS ID: 25026

AGE: 1| SEX: M|STATE: WA (United States)

Description

child found dead in bed 14Jan90. Had full check up 12Jan90 with immunizations DPT/HIB/Oral Polio

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Symptoms

Unevaluable event

Vaccines

VAX DATE: 01-12-1990| ONSET DATE: 01-14-1990| DAYS TO ONSET: 2
NameDose #TypeManufacturerLotRouteSite
POLIO VIRUS, ORAL (ORIMUNE) 0 OPV PFIZER\WYETH 244970 PO MO
DT ADSORBED (NO BRAND NAME) 0 DT LEDERLE LABORATORIES 229974 IM
HIB (PROHIBIT) 0 HIBV CONNAUGHT LABORATORIES 9A11092 IM

RECVDATE:07-09-1990
RPT_DATE:
CAGE_YR:
CAGE_MO:
DIED:Y
DATEDIED:01-14-1990
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:
FORM_VERS:
TODAYS_DATE:
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:
V_FUNDBY:

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