National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 26603

Case Details

VAERS ID: 26603 (history)  
Form: Version 1.0  
Age: 1.0  
Sex: Male  
Location: Colorado  
Vaccinated:1990-10-24
Onset:1990-10-29
   Days after vaccination:5
Submitted: 1990-11-05
   Days after onset:7
Entered: 1990-11-09
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0A21149 / 2 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0611B / 2 MO / PO

Administered by: Private       Purchased by: Private
Symptoms: Sudden infant death syndrome
SMQs:, Neonatal disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1990-10-29
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Proventil Syrup, Terbutaline
Current Illness: BPD, Oxygen Dependency
Preexisting Conditions: Premature Infant 31 wks Gest; Severe Bronchopulmonary Dysplasia; Growth retardation
Allergies:
Diagnostic Lab Data: Autopsy pending
CDC Split Type:

Write-up: Pt vaccinated with DTP/OPV found in bed about 10AM after put down for morning nap on 29OCT90. took to Hosp ER & unable to revive. Sudden Infant Death Syndrome.


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=26603


Copyright © 2020 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166