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This is VAERS ID 26112

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 26112
VAERS Form:
Age:0.2
Sex:Female
Location:Tennessee
Vaccinated:1990-09-11
Onset:1990-09-13
Submitted:0000-00-00
Entered:1990-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: UNK. DTP / UNCLASSIFIED - / - - / -
OPV: UNK. POLIOVIRUS LIVE ORAL TRIVALENT / UNCLASSIFIED - / - - / -

Administered by: Public      Purchased by: Unknown
Symptoms: SIDS

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-09-13
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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Child immunized with DTP/OPV vaccines on 11SEP90. Sudden Infant Death Syndrome.


Changed on 12/8/2009

VAERS ID: 26112 Before After
VAERS Form:
Age:0.2
Sex:Female
Location:Tennessee
Vaccinated:1990-09-11
Onset:1990-09-13
Submitted:0000-00-00
Entered:1990-10-02 1990-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: UNK. DTP DTP (NO BRAND NAME) / UNCLASSIFIED UNKNOWN MANUFACTURER - / - - / -
OPV: UNK. POLIOVIRUS LIVE ORAL TRIVALENT POLIO VIRUS, ORAL (NO BRAND NAME) / UNCLASSIFIED UNKNOWN MANUFACTURER - / - - / -

Administered by: Public      Purchased by: Unknown
Symptoms: SIDS, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-09-13
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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Child immunized with DTP/OPV vaccines on 11SEP90. Sudden Infant Death Syndrome.


Changed on 5/14/2017

VAERS ID: 26112 Before After
VAERS Form:
Age:0.2
Sex:Female
Location:Tennessee
Vaccinated:1990-09-11
Onset:1990-09-13
Submitted:0000-00-00
Entered:1990-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Public      Purchased by: Unknown
Symptoms: Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-09-13
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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Child immunized with DTP/OPV vaccines on 11SEP90. Sudden Infant Death Syndrome.


Changed on 9/14/2017

VAERS ID: 26112 Before After
VAERS Form:(blank) 1
Age:0.2
Sex:Female
Location:Tennessee
Vaccinated:1990-09-11
Onset:1990-09-13
Submitted:0000-00-00
Entered:1990-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK - / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK - / -

Administered by: Public      Purchased by: Unknown
Symptoms: Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-09-13
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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Child immunized with DTP/OPV vaccines on 11SEP90. Sudden Infant Death Syndrome.


Changed on 2/14/2018

VAERS ID: 26112 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:Tennessee
Vaccinated:1990-09-11
Onset:1990-09-13
Submitted:0000-00-00
Entered:1990-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Public      Purchased by: Unknown
Symptoms: Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-09-13
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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Child immunized with DTP/OPV vaccines on 11SEP90. Sudden Infant Death Syndrome.


Changed on 6/14/2018

VAERS ID: 26112 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:Tennessee
Vaccinated:1990-09-11
Onset:1990-09-13
Submitted:0000-00-00
Entered:1990-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Public      Purchased by: Unknown
Symptoms: Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-09-13
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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Child immunized with DTP/OPV vaccines on 11SEP90. Sudden Infant Death Syndrome.


Changed on 8/14/2018

VAERS ID: 26112 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:Tennessee
Vaccinated:1990-09-11
Onset:1990-09-13
Submitted:0000-00-00
Entered:1990-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Public      Purchased by: Unknown
Symptoms: Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-09-13
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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Child immunized with DTP/OPV vaccines on 11SEP90. Sudden Infant Death Syndrome.


Changed on 9/14/2018

VAERS ID: 26112 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:Tennessee
Vaccinated:1990-09-11
Onset:1990-09-13
Submitted:0000-00-00
Entered:1990-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Public      Purchased by: Unknown
Symptoms: Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-09-13
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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Child immunized with DTP/OPV vaccines on 11SEP90. Sudden Infant Death Syndrome.


Changed on 10/14/2018

VAERS ID: 26112 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:Tennessee
Vaccinated:1990-09-11
Onset:1990-09-13
Submitted:0000-00-00
Entered:1990-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Public      Purchased by: Unknown
Symptoms: Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-09-13
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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Child immunized with DTP/OPV vaccines on 11SEP90. Sudden Infant Death Syndrome.

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