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From the 2/18/2021 release of VAERS data:

This is VAERS ID 25543

Case Details

VAERS ID: 25543 (history)  
Form: Version 1.0  
Age: 0.3  
Sex: Unknown  
Location: Wisconsin  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 1990-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES - / UNK - / -

Administered by: Private       Purchased by: Unknown
Symptoms: Diarrhoea, Respiratory disorder
SMQs:, Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Respiratory failure (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
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:
Allergies:
Diagnostic Lab Data:
CDC Split Type: 9001123.01

Write-up: 4 month old infant received first DTP/OPV immun. & had no immediate problems, was apparently well & healthy. 9-10 days later, developed repiratory symptoms & diarrhea, then found dead the following day.


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