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From the 9/17/2021 release of VAERS data:

This is VAERS ID 25535



Case Details

VAERS ID: 25535 (history)  
Form: Version 1.0  
Age: 0.3  
Sex: Male  
Location: Ohio  
Vaccinated:1990-03-28
Onset:1990-03-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 271962 / 2 - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 259949 / 2 - / -

Administered by: Private       Purchased by: Unknown
Symptoms: Sudden infant death syndrome
SMQs:, Neonatal disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1990-03-28
   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 revealed no pathology in any organ system that could explain the death of this infant, therefore, this is a case of sudden death syndrome.
CDC Split Type: 9000592.01

Write-up: normal 4 moth old infant received DTP/OPV in office at on 28Mar90, put to bed at 10:00pm; found dead at 10:30 pm.


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