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This is VAERS ID 26483

Case Details

VAERS ID: 26483 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Unknown  
Location: Connecticut  
Vaccinated:1989-07-27
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 1990-10-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 244984 / UNK - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 250939 / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Convulsion, Hypertonia, Insomnia, Screaming, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1990-04-18
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: 900157501

Write-up: Pt vaccinated with 1st DTP/OPV on 27Jul89, developed loss of head control, screaming & vomiting, had sleep loss, limbs tense and developed seizures. Hospitalized many times between Sep-Dec89, received DT, condition worsened; Died 18APR90.


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