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This is VAERS ID 25026

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 25026
VAERS Form:
Age:1.0
Sex:Male
Location:Washington
Vaccinated:1990-01-12
Onset:1990-01-14
Submitted:0000-00-00
Entered:1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DT: DT ADSORBED PEDIATRIC / LEDERLE 229974 / - - / IM
HIBV: PROHIBIT / CONNAUGHT LABS 9A11092 / - - / IM
OPV: ORIMUNE / LEDERLE 244970 / - - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: REACT UNEVAL

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-01-14
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

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

Changed on 12/8/2009

VAERS ID: 25026 Before After
VAERS Form:
Age:1.0
Sex:Male
Location:Washington
Vaccinated:1990-01-12
Onset:1990-01-14
Submitted:0000-00-00
Entered:1990-07-10 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DT: DT ADSORBED PEDIATRIC DT ADSORBED (NO BRAND NAME) / LEDERLE LEDERLE LABORATORIES 229974 / - - / IM
HIBV: PROHIBIT HIB (PROHIBIT) / CONNAUGHT LABS CONNAUGHT LABORATORIES 9A11092 / - - / IM
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES 244970 / - - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Unevaluable event, REACT UNEVAL

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-01-14
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

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

Changed on 5/14/2017

VAERS ID: 25026 Before After
VAERS Form:
Age:1.0
Sex:Male
Location:Washington
Vaccinated:1990-01-12
Onset:1990-01-14
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DT: DT ADSORBED (NO BRAND NAME) / LEDERLE LABORATORIES 229974 / - - / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 9A11092 / - - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 244970 / - - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-01-14
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

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

Changed on 9/14/2017

VAERS ID: 25026 Before After
VAERS Form:(blank) 1
Age:1.0
Sex:Male
Location:Washington
Vaccinated:1990-01-12
Onset:1990-01-14
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DT: DT ADSORBED (NO BRAND NAME) / LEDERLE LABORATORIES 229974 / - UNK - / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 9A11092 / - UNK - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 244970 / - UNK - MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-01-14
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

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

Changed on 2/14/2018

VAERS ID: 25026 Before After
VAERS Form:1
Age:1.0
Sex:Male
Location:Washington
Vaccinated:1990-01-12
Onset:1990-01-14
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DT: DT ADSORBED (NO BRAND NAME) / LEDERLE LABORATORIES 229974 / UNK - / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 9A11092 / UNK - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 244970 / UNK MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-01-14
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

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

Changed on 6/14/2018

VAERS ID: 25026 Before After
VAERS Form:1
Age:1.0
Sex:Male
Location:Washington
Vaccinated:1990-01-12
Onset:1990-01-14
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DT: DT ADSORBED (NO BRAND NAME) / LEDERLE LABORATORIES 229974 / UNK - / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 9A11092 / UNK - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 244970 / UNK MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-01-14
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

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

Changed on 8/14/2018

VAERS ID: 25026 Before After
VAERS Form:1
Age:1.0
Sex:Male
Location:Washington
Vaccinated:1990-01-12
Onset:1990-01-14
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DT: DT ADSORBED (NO BRAND NAME) / LEDERLE LABORATORIES 229974 / UNK - / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 9A11092 / UNK - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 244970 / UNK MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-01-14
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

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

Changed on 9/14/2018

VAERS ID: 25026 Before After
VAERS Form:1
Age:1.0
Sex:Male
Location:Washington
Vaccinated:1990-01-12
Onset:1990-01-14
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DT: DT ADSORBED (NO BRAND NAME) / LEDERLE LABORATORIES 229974 / UNK - / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 9A11092 / UNK - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 244970 / UNK MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-01-14
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

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

Changed on 10/14/2018

VAERS ID: 25026 Before After
VAERS Form:1
Age:1.0
Sex:Male
Location:Washington
Vaccinated:1990-01-12
Onset:1990-01-14
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DT: DT ADSORBED (NO BRAND NAME) / LEDERLE LABORATORIES 229974 / UNK - / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 9A11092 / UNK - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 244970 / UNK MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-01-14
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

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

Changed on 12/24/2020

VAERS ID: 25026 Before After
VAERS Form:1
Age:1.0
Sex:Male
Location:Washington
Vaccinated:1990-01-12
Onset:1990-01-14
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DT: DT ADSORBED (NO BRAND NAME) / LEDERLE LABORATORIES 229974 / UNK - / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 9A11092 / UNK - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 244970 / UNK MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-01-14
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

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

Changed on 12/30/2020

VAERS ID: 25026 Before After
VAERS Form:1
Age:1.0
Sex:Male
Location:Washington
Vaccinated:1990-01-12
Onset:1990-01-14
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DT: DT ADSORBED (NO BRAND NAME) / LEDERLE LABORATORIES 229974 / UNK - / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 9A11092 / UNK - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 244970 / UNK MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-01-14
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

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

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=25026&WAYBACKHISTORY=ON


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