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This is VAERS ID 26890

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 26890
VAERS Form:
Age:0.3
Sex:Male
Location:Kansas
Vaccinated:0000-00-00
Onset:1990-01-25
Submitted:0000-00-00
Entered:1990-12-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 256960 / - - / -
OPV: ORIMUNE / LEDERLE 256930 / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: SIDS, PNEUMONIA

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-01-25
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: Post mortem - "slight pneumonia"
CDC 'Split Type':

Write-up: Pt vax with DTP/OPV was doing well on 25JAN90 taken to sitter. Found dead in crib in afternoon.


Changed on 12/30/2006

VAERS ID: 26890 Before After
VAERS Form:
Age:0.3
Sex:Male
Location:Kansas
Vaccinated:0000-00-00
Onset:1990-01-25
Submitted:0000-00-00
Entered:1990-12-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 256960 / - - / -
OPV: ORIMUNE / LEDERLE 256930 / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: SIDS, PNEUMONIA

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-01-25
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: Post mortem - "slight pneumonia" /"slight pneumonia/"
CDC 'Split Type':

Write-up: Pt vax with DTP/OPV was doing well on 25JAN90 taken to sitter. Found dead in crib in afternoon.


Changed on 12/8/2009

VAERS ID: 26890 Before After
VAERS Form:
Age:0.3
Sex:Male
Location:Kansas
Vaccinated:0000-00-00
Onset:1990-01-25
Submitted:0000-00-00
Entered:1990-12-06 1990-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL DTP (TRI-IMMUNOL) / LEDERLE LEDERLE LABORATORIES 256960 / - - / -
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES 256930 / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Pneumonia, SIDS, Sudden infant death syndrome, PNEUMONIA

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-01-25
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: Post mortem - /"slight pneumonia/" "slight pneumonia"
CDC 'Split Type':

Write-up: Pt vax with DTP/OPV was doing well on 25JAN90 taken to sitter. Found dead in crib in afternoon.


Changed on 5/14/2017

VAERS ID: 26890 Before After
VAERS Form:
Age:0.3
Sex:Male
Location:Kansas
Vaccinated:0000-00-00
Onset:1990-01-25
Submitted:0000-00-00
Entered:1990-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 256960 / - - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 256930 / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Pneumonia, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-01-25
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: Post mortem - "slight pneumonia"
CDC 'Split Type':

Write-up: Pt vax with DTP/OPV was doing well on 25JAN90 taken to sitter. Found dead in crib in afternoon.


Changed on 9/14/2017

VAERS ID: 26890 Before After
VAERS Form:(blank) 1
Age:0.3
Sex:Male
Location:Kansas
Vaccinated:0000-00-00
Onset:1990-01-25
Submitted:0000-00-00
Entered:1990-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 256960 / - UNK - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 256930 / - UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Pneumonia, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-01-25
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: Post mortem - "slight pneumonia"
CDC 'Split Type':

Write-up: Pt vax with DTP/OPV was doing well on 25JAN90 taken to sitter. Found dead in crib in afternoon.


Changed on 2/14/2018

VAERS ID: 26890 Before After
VAERS Form:1
Age:0.3
Sex:Male
Location:Kansas
Vaccinated:0000-00-00
Onset:1990-01-25
Submitted:0000-00-00
Entered:1990-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 256960 / UNK - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 256930 / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Pneumonia, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-01-25
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: Post mortem - "slight pneumonia"
CDC 'Split Type':

Write-up: Pt vax with DTP/OPV was doing well on 25JAN90 taken to sitter. Found dead in crib in afternoon.


Changed on 6/14/2018

VAERS ID: 26890 Before After
VAERS Form:1
Age:0.3
Sex:Male
Location:Kansas
Vaccinated:0000-00-00
Onset:1990-01-25
Submitted:0000-00-00
Entered:1990-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 256960 / UNK - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 256930 / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Pneumonia, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-01-25
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: Post mortem - "slight pneumonia"
CDC 'Split Type':

Write-up: Pt vax with DTP/OPV was doing well on 25JAN90 taken to sitter. Found dead in crib in afternoon.


Changed on 8/14/2018

VAERS ID: 26890 Before After
VAERS Form:1
Age:0.3
Sex:Male
Location:Kansas
Vaccinated:0000-00-00
Onset:1990-01-25
Submitted:0000-00-00
Entered:1990-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 256960 / UNK - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 256930 / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Pneumonia, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-01-25
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: Post mortem - "slight pneumonia"
CDC 'Split Type':

Write-up: Pt vax with DTP/OPV was doing well on 25JAN90 taken to sitter. Found dead in crib in afternoon.


Changed on 9/14/2018

VAERS ID: 26890 Before After
VAERS Form:1
Age:0.3
Sex:Male
Location:Kansas
Vaccinated:0000-00-00
Onset:1990-01-25
Submitted:0000-00-00
Entered:1990-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 256960 / UNK - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 256930 / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Pneumonia, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-01-25
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: Post mortem - "slight pneumonia"
CDC 'Split Type':

Write-up: Pt vax with DTP/OPV was doing well on 25JAN90 taken to sitter. Found dead in crib in afternoon.


Changed on 10/14/2018

VAERS ID: 26890 Before After
VAERS Form:1
Age:0.3
Sex:Male
Location:Kansas
Vaccinated:0000-00-00
Onset:1990-01-25
Submitted:0000-00-00
Entered:1990-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 256960 / UNK - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 256930 / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Pneumonia, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-01-25
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: Post mortem - "slight pneumonia"
CDC 'Split Type':

Write-up: Pt vax with DTP/OPV was doing well on 25JAN90 taken to sitter. Found dead in crib in afternoon.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=26890&WAYBACKHISTORY=ON


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