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This is VAERS ID 26994

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 26994
VAERS Form:
Age:0.3
Sex:Male
Location:Pennsylvania
Vaccinated:1990-11-20
Onset:1990-11-22
Submitted:1990-12-06
Entered:1990-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 285915 / 0 LL / IM
OPV: ORIMUNE / LEDERLE 277949 / 0 - / PO

Administered by: Public      Purchased by: Unknown
Symptoms: SIDS, APNEA

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-11-22
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:
CDC 'Split Type':

Write-up: Pt vaccinated with DTP/OPV child in bed w/parents - not breathing - taken to ER Indiana. Autopsy done - Dx SIDS


Changed on 12/8/2009

VAERS ID: 26994 Before After
VAERS Form:
Age:0.3
Sex:Male
Location:Pennsylvania
Vaccinated:1990-11-20
Onset:1990-11-22
Submitted:1990-12-06
Entered:1990-12-18 1990-12-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL DTP (TRI-IMMUNOL) / LEDERLE LEDERLE LABORATORIES 285915 / 0 LL / IM
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES 277949 / 0 - / PO

Administered by: Public      Purchased by: Unknown Public
Symptoms: Apnoea, SIDS, Sudden infant death syndrome, APNEA

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-11-22
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:
CDC 'Split Type': (blank) PA907

Write-up: Pt vaccinated with DTP/OPV child in bed w/parents - not breathing - taken to ER Indiana. Autopsy done - Dx SIDS


Changed on 5/14/2017

VAERS ID: 26994 Before After
VAERS Form:
Age:0.3
Sex:Male
Location:Pennsylvania
Vaccinated:1990-11-20
Onset:1990-11-22
Submitted:1990-12-06
Entered:1990-12-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 285915 / 0 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 277949 / 0 - / PO

Administered by: Public      Purchased by: Public
Symptoms: Apnoea, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-11-22
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:
CDC 'Split Type': PA907

Write-up: Pt vaccinated with DTP/OPV child in bed w/parents - not breathing - taken to ER Indiana. Autopsy done - Dx SIDS


Changed on 9/14/2017

VAERS ID: 26994 Before After
VAERS Form:(blank) 1
Age:0.3
Sex:Male
Location:Pennsylvania
Vaccinated:1990-11-20
Onset:1990-11-22
Submitted:1990-12-06
Entered:1990-12-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 285915 / 0 1 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 277949 / 0 1 - MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Apnoea, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-11-22
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:
CDC 'Split Type': PA907

Write-up: Pt vaccinated with DTP/OPV child in bed w/parents - not breathing - taken to ER Indiana. Autopsy done - Dx SIDS


Changed on 2/14/2018

VAERS ID: 26994 Before After
VAERS Form:1
Age:0.3
Sex:Male
Location:Pennsylvania
Vaccinated:1990-11-20
Onset:1990-11-22
Submitted:1990-12-06
Entered:1990-12-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 285915 / 1 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 277949 / 1 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Apnoea, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-11-22
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:
CDC 'Split Type': PA907

Write-up: Pt vaccinated with DTP/OPV child in bed w/parents - not breathing - taken to ER Indiana. Autopsy done - Dx SIDS


Changed on 6/14/2018

VAERS ID: 26994 Before After
VAERS Form:1
Age:0.3
Sex:Male
Location:Pennsylvania
Vaccinated:1990-11-20
Onset:1990-11-22
Submitted:1990-12-06
Entered:1990-12-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 285915 / 1 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 277949 / 1 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Apnoea, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-11-22
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:
CDC 'Split Type': PA907

Write-up: Pt vaccinated with DTP/OPV child in bed w/parents - not breathing - taken to ER Indiana. Autopsy done - Dx SIDS


Changed on 8/14/2018

VAERS ID: 26994 Before After
VAERS Form:1
Age:0.3
Sex:Male
Location:Pennsylvania
Vaccinated:1990-11-20
Onset:1990-11-22
Submitted:1990-12-06
Entered:1990-12-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 285915 / 1 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 277949 / 1 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Apnoea, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-11-22
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:
CDC 'Split Type': PA907

Write-up: Pt vaccinated with DTP/OPV child in bed w/parents - not breathing - taken to ER Indiana. Autopsy done - Dx SIDS


Changed on 9/14/2018

VAERS ID: 26994 Before After
VAERS Form:1
Age:0.3
Sex:Male
Location:Pennsylvania
Vaccinated:1990-11-20
Onset:1990-11-22
Submitted:1990-12-06
Entered:1990-12-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 285915 / 1 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 277949 / 1 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Apnoea, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-11-22
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:
CDC 'Split Type': PA907

Write-up: Pt vaccinated with DTP/OPV child in bed w/parents - not breathing - taken to ER Indiana. Autopsy done - Dx SIDS


Changed on 10/14/2018

VAERS ID: 26994 Before After
VAERS Form:1
Age:0.3
Sex:Male
Location:Pennsylvania
Vaccinated:1990-11-20
Onset:1990-11-22
Submitted:1990-12-06
Entered:1990-12-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 285915 / 1 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 277949 / 1 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Apnoea, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-11-22
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:
CDC 'Split Type': PA907

Write-up: Pt vaccinated with DTP/OPV child in bed w/parents - not breathing - taken to ER Indiana. Autopsy done - Dx SIDS

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