This is VAERS ID 25530

Administered by: Private       Purchased by: Unknown
Symptoms: Agitation, Pyrexia, Sudden infant death syndrome
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Neonatal disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1990-06-05
   Days after onset: 1
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: no relevant hx, no siblings
Allergies:
Diagnostic Lab Data:
CDC Split Type: 9001011.01

Write-up: Pt had low grade fever & fussiness within 12 hrs /p vaccination, slept well that evenig. Following moring infant was fine; taken to babysitter and was placed in crib for nap. Infant was found dead ar 1:00 pm. Autospy report list SIDS