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This is VAERS ID 25989

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 25989
VAERS Form:
Age:1.8
Sex:Female
Location:Hawaii
Vaccinated:1989-09-12
Onset:1989-09-12
Submitted:0000-00-00
Entered:1990-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP / CONNAUGHT LABS 9G101042 / - - / IM
OPV: ORIMUNE / LEDERLE 595 / - - / PO

Administered by: Private      Purchased by: Unknown
Symptoms: AGITATION, DYSPNEA, ABDO ENLARGE, ATELECTASIS, STOMACH DILAT

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1989-09-13
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: Premature infant w/numerous medical problems.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/OPV developed cardiorespiratory arrest less than 24 hrs after vax. Pt noted to have abd distension and fussiness along with some respiratory distress prior to arrest. Pt was premature infant w/several med problems.


Changed on 12/8/2009

VAERS ID: 25989 Before After
VAERS Form:
Age:1.8
Sex:Female
Location:Hawaii
Vaccinated:1989-09-12
Onset:1989-09-12
Submitted:0000-00-00
Entered:1990-09-25 1990-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP DTP (NO BRAND NAME) / CONNAUGHT LABS CONNAUGHT LABORATORIES 9G101042 / - - / IM
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES 595 / - - / PO

Administered by: Private      Purchased by: Unknown
Symptoms: Abdominal distension, Agitation, Atelectasis, Dyspnoea, Gastric dilatation, AGITATION, DYSPNEA, ABDO ENLARGE, ATELECTASIS, STOMACH DILAT

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1989-09-13
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: Premature infant w/numerous medical problems.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/OPV developed cardiorespiratory arrest less than 24 hrs after vax. Pt noted to have abd distension and fussiness along with some respiratory distress prior to arrest. Pt was premature infant w/several med problems.


Changed on 5/14/2017

VAERS ID: 25989 Before After
VAERS Form:
Age:1.8
Sex:Female
Location:Hawaii
Vaccinated:1989-09-12
Onset:1989-09-12
Submitted:0000-00-00
Entered:1990-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 9G101042 / - - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 595 / - - / PO

Administered by: Private      Purchased by: Unknown
Symptoms: Abdominal distension, Agitation, Atelectasis, Dyspnoea, Gastric dilatation

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1989-09-13
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: Premature infant w/numerous medical problems.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/OPV developed cardiorespiratory arrest less than 24 hrs after vax. Pt noted to have abd distension and fussiness along with some respiratory distress prior to arrest. Pt was premature infant w/several med problems.


Changed on 9/14/2017

VAERS ID: 25989 Before After
VAERS Form:(blank) 1
Age:1.8
Sex:Female
Location:Hawaii
Vaccinated:1989-09-12
Onset:1989-09-12
Submitted:0000-00-00
Entered:1990-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 9G101042 / - UNK - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 595 / - UNK - MO / PO

Administered by: Private      Purchased by: Unknown
Symptoms: Abdominal distension, Agitation, Atelectasis, Dyspnoea, Gastric dilatation

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1989-09-13
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: Premature infant w/numerous medical problems.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/OPV developed cardiorespiratory arrest less than 24 hrs after vax. Pt noted to have abd distension and fussiness along with some respiratory distress prior to arrest. Pt was premature infant w/several med problems.


Changed on 2/14/2018

VAERS ID: 25989 Before After
VAERS Form:1
Age:1.8
Sex:Female
Location:Hawaii
Vaccinated:1989-09-12
Onset:1989-09-12
Submitted:0000-00-00
Entered:1990-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 9G101042 / UNK - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 595 / UNK MO / PO

Administered by: Private      Purchased by: Unknown
Symptoms: Abdominal distension, Agitation, Atelectasis, Dyspnoea, Gastric dilatation

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1989-09-13
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: Premature infant w/numerous medical problems.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/OPV developed cardiorespiratory arrest less than 24 hrs after vax. Pt noted to have abd distension and fussiness along with some respiratory distress prior to arrest. Pt was premature infant w/several med problems.


Changed on 6/14/2018

VAERS ID: 25989 Before After
VAERS Form:1
Age:1.8
Sex:Female
Location:Hawaii
Vaccinated:1989-09-12
Onset:1989-09-12
Submitted:0000-00-00
Entered:1990-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 9G101042 / UNK - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 595 / UNK MO / PO

Administered by: Private      Purchased by: Unknown
Symptoms: Abdominal distension, Agitation, Atelectasis, Dyspnoea, Gastric dilatation

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1989-09-13
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: Premature infant w/numerous medical problems.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/OPV developed cardiorespiratory arrest less than 24 hrs after vax. Pt noted to have abd distension and fussiness along with some respiratory distress prior to arrest. Pt was premature infant w/several med problems.


Changed on 8/14/2018

VAERS ID: 25989 Before After
VAERS Form:1
Age:1.8
Sex:Female
Location:Hawaii
Vaccinated:1989-09-12
Onset:1989-09-12
Submitted:0000-00-00
Entered:1990-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 9G101042 / UNK - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 595 / UNK MO / PO

Administered by: Private      Purchased by: Unknown
Symptoms: Abdominal distension, Agitation, Atelectasis, Dyspnoea, Gastric dilatation

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1989-09-13
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: Premature infant w/numerous medical problems.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/OPV developed cardiorespiratory arrest less than 24 hrs after vax. Pt noted to have abd distension and fussiness along with some respiratory distress prior to arrest. Pt was premature infant w/several med problems.


Changed on 9/14/2018

VAERS ID: 25989 Before After
VAERS Form:1
Age:1.8
Sex:Female
Location:Hawaii
Vaccinated:1989-09-12
Onset:1989-09-12
Submitted:0000-00-00
Entered:1990-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 9G101042 / UNK - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 595 / UNK MO / PO

Administered by: Private      Purchased by: Unknown
Symptoms: Abdominal distension, Agitation, Atelectasis, Dyspnoea, Gastric dilatation

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1989-09-13
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: Premature infant w/numerous medical problems.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/OPV developed cardiorespiratory arrest less than 24 hrs after vax. Pt noted to have abd distension and fussiness along with some respiratory distress prior to arrest. Pt was premature infant w/several med problems.


Changed on 10/14/2018

VAERS ID: 25989 Before After
VAERS Form:1
Age:1.8
Sex:Female
Location:Hawaii
Vaccinated:1989-09-12
Onset:1989-09-12
Submitted:0000-00-00
Entered:1990-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 9G101042 / UNK - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 595 / UNK MO / PO

Administered by: Private      Purchased by: Unknown
Symptoms: Abdominal distension, Agitation, Atelectasis, Dyspnoea, Gastric dilatation

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1989-09-13
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: Premature infant w/numerous medical problems.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/OPV developed cardiorespiratory arrest less than 24 hrs after vax. Pt noted to have abd distension and fussiness along with some respiratory distress prior to arrest. Pt was premature infant w/several med problems.

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