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This is VAERS ID 26285

Case Details

VAERS ID: 26285 (history)  
Form: Version 1.0  
Age: 0.4  
Sex: Male  
Location: Georgia  
Vaccinated:1990-03-19
Onset:1990-03-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 1990-10-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 256962 / UNK - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0599C / UNK MO / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1990-03-20
   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:
CDC Split Type: 9001628.02

Write-up: CDC Reports: 5 mo infant received DTP/OPV on 19MAR90 and died 20AMR90. Patient was given Tylenol for a low grade fever 3 hrs before death.


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