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This is VAERS ID 26593

Case Details

VAERS ID: 26593 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Male  
Location: California  
Vaccinated:1990-10-29
Onset:1990-10-31
   Days after vaccination:2
Submitted: 1990-11-02
   Days after onset:2
Entered: 1990-11-08
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0G11097 / UNK - / L
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH - / UNK MO / PO

Administered by: Private       Purchased by: Private
Symptoms: Apnoea
SMQs:, Acute central respiratory depression (narrow), Respiratory failure (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1990-10-31
   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: Nystatin Ointment
Current Illness: Diaper Rash
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt vaccinated with DTP/OPV no adverse effects according to father; Pt was fine the day after immunization. Pt discovered not breathing at 2AM 31OCT.


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