|
| VAERS ID: |
26288 (history) |
| Form: |
Version 1.0 |
| Age: |
0.2 |
| Sex: |
Male |
| Location: |
New Hampshire |
| Vaccinated: | 1989-11-21 |
| Onset: | 1989-11-21 |
| Days after vaccination: | 0 |
| Submitted: |
0000-00-00 |
| Entered: |
1990-10-19 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES |
256957 / UNK |
- / - |
| OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH |
0599C / UNK |
MO / PO |
Administered by: Unknown Purchased by: Unknown
Symptoms: Unevaluable event
SMQs:
Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 1989-11-21
Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: 9001629.03
Write-up: CDC Reports: 2 mo infant received DTP/OPV on 8NOV89 and 21NOV89. |
|
| VAERS ID: |
26289 (history) |
| Form: |
Version 1.0 |
| Age: |
0.2 |
| Sex: |
Male |
| Location: |
New Hampshire |
| Vaccinated: | 1989-10-11 |
| Onset: | 1989-10-13 |
| Days after vaccination: | 2 |
| Submitted: |
0000-00-00 |
| Entered: |
1990-10-19 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES |
256957 / UNK |
- / - |
| OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH |
247439 / UNK |
MO / PO |
Administered by: Unknown Purchased by: Unknown
Symptoms: Unevaluable event
SMQs:
Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 1989-10-13
Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Known balanced translocation, chromosome 245 cause of death unknown, post WNL, Tox pending.
CDC Split Type: 9001629.04
Write-up: CDC reports: 3 mo infant received DTP/OPV on 11OCT89 and died 13OCT89. |
|
| VAERS ID: |
26290 (history) |
| Form: |
Version 1.0 |
| Age: |
0.4 |
| Sex: |
Male |
| Location: |
Louisiana |
| Vaccinated: | 1990-01-25 |
| Onset: | 1990-02-03 |
| Days after vaccination: | 9 |
| Submitted: |
0000-00-00 |
| Entered: |
1990-10-19 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES |
256965 / UNK |
- / - |
| OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH |
0592B / UNK |
MO / PO |
Administered by: Unknown Purchased by: Unknown
Symptoms: Unevaluable event
SMQs:
Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 1990-02-03
Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: 9001630.01
Write-up: CDC reports: 5 mo infant received DTP/OPV on 25JAN90 and died 3FEB90. |
|
| VAERS ID: |
26291 (history) |
| Form: |
Version 1.0 |
| Age: |
0.3 |
| Sex: |
Male |
| Location: |
Connecticut |
| Vaccinated: | 1989-11-08 |
| Onset: | 1989-11-08 |
| Days after vaccination: | 0 |
| Submitted: |
0000-00-00 |
| Entered: |
1990-10-19 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES |
253980 / UNK |
- / - |
| OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH |
256928 / UNK |
- / - |
Administered by: Unknown Purchased by: Unknown
Symptoms: Unevaluable event
SMQs:
Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 1989-11-08
Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Autopsy performed
CDC Split Type: 9001631.01
Write-up: CDC reports 4 mo infant received DTP/OPV on 8NOV89 and died 4 hrs later. |
|
| VAERS ID: |
26292 (history) |
| Form: |
Version 1.0 |
| Age: |
0.3 |
| Sex: |
Male |
| Location: |
Connecticut |
| Vaccinated: | 1989-10-31 |
| Onset: | 1989-11-07 |
| Days after vaccination: | 7 |
| Submitted: |
0000-00-00 |
| Entered: |
1990-10-19 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES |
253980 / UNK |
- / - |
| OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH |
250939 / UNK |
MO / PO |
Administered by: Unknown Purchased by: Unknown
Symptoms: Unevaluable event
SMQs:
Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 1989-11-07
Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Gross post mortem negative; Autopsy performed.
CDC Split Type: 9001631.02
Write-up: CDC Reports: 3 mo infant received DTP/OPV on 31OCT89 and died 7NOV89. |
|
| VAERS ID: |
26293 (history) |
| Form: |
Version 1.0 |
| Age: |
0.2 |
| Sex: |
Male |
| Location: |
Tennessee |
| Vaccinated: | 1989-09-27 |
| Onset: | 1989-09-29 |
| Days after vaccination: | 2 |
| Submitted: |
0000-00-00 |
| Entered: |
1990-10-19 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES |
256959 / UNK |
- / - |
| OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH |
0594F / UNK |
MO / PO |
Administered by: Unknown Purchased by: Unknown
Symptoms: Sudden infant death syndrome
SMQs:, Neonatal disorders (narrow)
Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 1989-09-29
Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: No Autopsy. SIDS on death certificate, also natural
CDC Split Type: 9001633.01
Write-up: CDC Reports: 2mo infant received DTP/OPV on 27SEP89 and died 29SEP89. |
|
| VAERS ID: |
26294 (history) |
| Form: |
Version 1.0 |
| Age: |
0.4 |
| Sex: |
Female |
| Location: |
Tennessee |
| Vaccinated: | 1990-01-23 |
| Onset: | 1990-01-24 |
| Days after vaccination: | 1 |
| Submitted: |
0000-00-00 |
| Entered: |
1990-10-19 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES |
256959 / UNK |
- / - |
| OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH |
0594F / UNK |
MO / PO |
Administered by: Unknown Purchased by: Unknown
Symptoms: Unevaluable event
SMQs:
Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 1990-01-24
Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: No illness following previous immunization.
Allergies:
Diagnostic Lab Data:
CDC Split Type: 9001633.02
Write-up: CDC Reports: 5 mo infant receivd DTP/OPV on 23JAN90 and died 24JAN90. |
|
| VAERS ID: |
26295 (history) |
| Form: |
Version 1.0 |
| Age: |
0.2 |
| Sex: |
Male |
| Location: |
Tennessee |
| Vaccinated: | 1989-11-14 |
| Onset: | 1989-11-17 |
| Days after vaccination: | 3 |
| Submitted: |
0000-00-00 |
| Entered: |
1990-10-19 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES |
256959 / UNK |
- / - |
| OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH |
0593D / UNK |
MO / PO |
Administered by: Unknown Purchased by: Unknown
Symptoms: Unevaluable event
SMQs:
Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 1989-11-17
Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: 9001633.03
Write-up: CDC Reports: 2 mo infant received DTP/OPV on 14NOV89 and died 17NOV89. |
|
| VAERS ID: |
26296 (history) |
| Form: |
Version 1.0 |
| Age: |
0.2 |
| Sex: |
Male |
| Location: |
Texas |
| Vaccinated: | 1989-12-12 |
| Onset: | 1989-12-12 |
| Days after vaccination: | 0 |
| Submitted: |
0000-00-00 |
| Entered: |
1990-10-19 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES |
256962 / UNK |
- / - |
| OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH |
0600H / UNK |
MO / PO |
Administered by: Unknown Purchased by: Unknown
Symptoms: Unevaluable event
SMQs:
Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 1989-12-12
Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: 9001635.01
Write-up: CDC Reports: 3 mo infant received DTP/OPV on 12DEC89 and died same day. Infant was put down for a nap approx 1PM. Mother checked on infant approx 4PM no response dead on arrival at hospital. |
|
| VAERS ID: |
26297 (history) |
| Form: |
Version 1.0 |
| Age: |
0.2 |
| Sex: |
Male |
| Location: |
Vermont |
| Vaccinated: | 1989-12-14 |
| Onset: | 1990-01-01 |
| Days after vaccination: | 18 |
| Submitted: |
0000-00-00 |
| Entered: |
1990-10-19 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES |
256959 / UNK |
- / - |
| OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH |
259943 / UNK |
- / - |
Administered by: Unknown Purchased by: Unknown
Symptoms: Apnoea,
Brain oedema,
Hypoxia,
Infection,
Lung disorder,
Petechiae,
Respiratory disorder,
Sudden infant death syndrome
SMQs:, Asthma/bronchospasm (broad), Haemorrhage terms (excl laboratory terms) (narrow), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Hyponatraemia/SIADH (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Neonatal disorders (narrow), Respiratory failure (narrow), Infective pneumonia (broad)
Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 1990-01-01
Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: 9001636.01
Write-up: CDC Reports: 2 mo infant received DTP/OPV on 14DEC89 and died 1JAN90. |
|
