VAERS ID: 25026

AGE: 1| SEX: M|STATE: WA

Description

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

Symptoms

Unevaluable event

Vaccines

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

RECVDATE:07-09-1990
RPT_DATE:
CAGE_YR:
CAGE_MO:
DIED:Y
DATEDIED:01-14-1990
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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