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This is VAERS ID 26241

Case Details

VAERS ID: 26241 (history)  
Form: Version 1.0  
Age: 2.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:1989-06-20
Onset:1989-06-23
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 1990-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 232968 / 4 - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: CSF test abnormal, Cerebrovascular disorder, Convulsion, Delirium, Encephalopathy, Hepatic necrosis, Neuropathy, Pneumonia
SMQs:, Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Dementia (broad), Convulsions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Generalised convulsive seizures following immunisation (narrow), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (narrow), Dehydration (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1990-03-28
   Days after onset: 278
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 60 days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: 9001578.01

Write-up: Pt vaccinated with DTP then death occurred 3/90. Cause of death listed as reaction to DTP vaccination.


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