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This is VAERS ID 26250

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 26250
VAERS Form:
Age:0.2
Sex:Unknown
Location:California
Vaccinated:1990-08-29
Onset:1990-08-31
Submitted:0000-00-00
Entered:1990-10-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 283913 / 0 LL / IM
OPV: ORIMUNE / LEDERLE 265925 / 0 - / PO

Administered by: Public      Purchased by: Unknown
Symptoms: SIDS, HYPOKINESIA, CYANOSIS, APNEA

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-08-31
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: Autopsey - SFC&C coroner
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/OPV found shortly after being put down for nap unresponsibe, apnea, blue & resuscitation unsuccessful. Verbal autopsey Dr SIDS.


Changed on 12/8/2009

VAERS ID: 26250 Before After
VAERS Form:
Age:0.2
Sex:Unknown
Location:California
Vaccinated:1990-08-29
Onset:1990-08-31
Submitted:0000-00-00
Entered:1990-10-17 1990-10-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL DTP (TRI-IMMUNOL) / LEDERLE LEDERLE LABORATORIES 283913 / 0 LL / IM
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES 265925 / 0 - / PO

Administered by: Public      Purchased by: Unknown Public
Symptoms: Apnoea, Cyanosis, Hypokinesia, SIDS, Sudden infant death syndrome, HYPOKINESIA, CYANOSIS, APNEA

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-08-31
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: Autopsey - SFC&C coroner
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/OPV found shortly after being put down for nap unresponsibe, apnea, blue & resuscitation unsuccessful. Verbal autopsey Dr SIDS.


Changed on 5/14/2017

VAERS ID: 26250 Before After
VAERS Form:
Age:0.2
Sex:Unknown
Location:California
Vaccinated:1990-08-29
Onset:1990-08-31
Submitted:0000-00-00
Entered:1990-10-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 283913 / 0 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 265925 / 0 - / PO

Administered by: Public      Purchased by: Public
Symptoms: Apnoea, Cyanosis, Hypokinesia, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-08-31
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: Autopsey - SFC&C coroner
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/OPV found shortly after being put down for nap unresponsibe, apnea, blue & resuscitation unsuccessful. Verbal autopsey Dr SIDS.


Changed on 9/14/2017

VAERS ID: 26250 Before After
VAERS Form:(blank) 1
Age:0.2
Sex:Unknown
Location:California
Vaccinated:1990-08-29
Onset:1990-08-31
Submitted:0000-00-00
Entered:1990-10-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 283913 / 0 1 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 265925 / 0 1 - MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Apnoea, Cyanosis, Hypokinesia, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-08-31
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: Autopsey - SFC&C coroner
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/OPV found shortly after being put down for nap unresponsibe, apnea, blue & resuscitation unsuccessful. Verbal autopsey Dr SIDS.


Changed on 2/14/2018

VAERS ID: 26250 Before After
VAERS Form:1
Age:0.2
Sex:Unknown
Location:California
Vaccinated:1990-08-29
Onset:1990-08-31
Submitted:0000-00-00
Entered:1990-10-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 283913 / 1 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 265925 / 1 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Apnoea, Cyanosis, Hypokinesia, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-08-31
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: Autopsey - SFC&C coroner
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/OPV found shortly after being put down for nap unresponsibe, apnea, blue & resuscitation unsuccessful. Verbal autopsey Dr SIDS.


Changed on 6/14/2018

VAERS ID: 26250 Before After
VAERS Form:1
Age:0.2
Sex:Unknown
Location:California
Vaccinated:1990-08-29
Onset:1990-08-31
Submitted:0000-00-00
Entered:1990-10-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 283913 / 1 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 265925 / 1 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Apnoea, Cyanosis, Hypokinesia, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-08-31
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: Autopsey - SFC&C coroner
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/OPV found shortly after being put down for nap unresponsibe, apnea, blue & resuscitation unsuccessful. Verbal autopsey Dr SIDS.


Changed on 8/14/2018

VAERS ID: 26250 Before After
VAERS Form:1
Age:0.2
Sex:Unknown
Location:California
Vaccinated:1990-08-29
Onset:1990-08-31
Submitted:0000-00-00
Entered:1990-10-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 283913 / 1 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 265925 / 1 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Apnoea, Cyanosis, Hypokinesia, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-08-31
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: Autopsey - SFC&C coroner
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/OPV found shortly after being put down for nap unresponsibe, apnea, blue & resuscitation unsuccessful. Verbal autopsey Dr SIDS.


Changed on 9/14/2018

VAERS ID: 26250 Before After
VAERS Form:1
Age:0.2
Sex:Unknown
Location:California
Vaccinated:1990-08-29
Onset:1990-08-31
Submitted:0000-00-00
Entered:1990-10-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 283913 / 1 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 265925 / 1 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Apnoea, Cyanosis, Hypokinesia, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-08-31
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: Autopsey - SFC&C coroner
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/OPV found shortly after being put down for nap unresponsibe, apnea, blue & resuscitation unsuccessful. Verbal autopsey Dr SIDS.


Changed on 10/14/2018

VAERS ID: 26250 Before After
VAERS Form:1
Age:0.2
Sex:Unknown
Location:California
Vaccinated:1990-08-29
Onset:1990-08-31
Submitted:0000-00-00
Entered:1990-10-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 283913 / 1 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 265925 / 1 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Apnoea, Cyanosis, Hypokinesia, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-08-31
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: Autopsey - SFC&C coroner
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/OPV found shortly after being put down for nap unresponsibe, apnea, blue & resuscitation unsuccessful. Verbal autopsey Dr SIDS.

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