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) Unknown OPV PFIZER\WYETH 244970 PO MO
DT ADSORBED (NO BRAND NAME) Unknown DT LEDERLE LABORATORIES 229974 IM Unknown
HIB (PROHIBIT) Unknown HIBV CONNAUGHT LABORATORIES 9A11092 IM Unknown

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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