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This is VAERS ID 47375

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 47375
VAERS Form:
Age:0.2
Sex:Male
Location:Tennessee
Vaccinated:1992-10-29
Onset:1992-10-30
Submitted:1992-11-03
Entered:1992-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 322914 / 0 RL / IM
HEP: HEPTAVAX / MSD 1158V / 0 LL / IM
HIBV: HIBTITER / LEDERLE(PRAXIS) M155JA / 0 LL / IM
OPV: ORIMUNE / LEDERLE 0661D / 0 - / PO

Administered by: Public      Purchased by: Unknown
Symptoms: SIDS, EDEMA LUNG, LUNG DIS

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-10-30
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: NONE
Current Illness: had had MD exam 2 days prior;
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: DTP/OPV/HIB/HBV were given 29OCT92 2PM pt found dead 30OCT92 approx 9AM of apparent crib death;


Changed on 12/8/2009

VAERS ID: 47375 Before After
VAERS Form:
Age:0.2
Sex:Male
Location:Tennessee
Vaccinated:1992-10-29
Onset:1992-10-30
Submitted:1992-11-03
Entered:1992-11-30 1992-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL DTP (TRI-IMMUNOL) / LEDERLE LEDERLE LABORATORIES 322914 / 0 RL / IM
HEP: HEPTAVAX HEP B (HEPTAVAX) / MSD MERCK & CO. INC. 1158V / 0 LL / IM
HIBV: HIBTITER HIB (HIBTITER) / LEDERLE(PRAXIS) LEDERLE PRAXSIS M155JA / 0 LL / IM
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES 0661D / 0 - / PO

Administered by: Public      Purchased by: Unknown Public
Symptoms: Lung disorder, Pulmonary oedema, SIDS, Sudden infant death syndrome, EDEMA LUNG, LUNG DIS

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-10-30
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: NONE
Current Illness: had had MD exam 2 days prior;
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) TN92142

Write-up: DTP/OPV/HIB/HBV were given 29OCT92 2PM pt found dead 30OCT92 approx 9AM of apparent crib death;


Changed on 8/31/2010

VAERS ID: 47375 Before After
VAERS Form:
Age:0.2
Sex:Male
Location:Tennessee
Vaccinated:1992-10-29
Onset:1992-10-30
Submitted:1992-11-03
Entered:1992-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 322914 / 0 RL / IM
HEP: HEP B (HEPTAVAX) HEP B (FOREIGN) / MERCK & CO. INC. 1158V / 0 LL / IM
HIBV: HIB (HIBTITER) / LEDERLE PRAXSIS M155JA / 0 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES 0661D / 0 - / PO

Administered by: Public      Purchased by: Public
Symptoms: Lung disorder, Pulmonary oedema, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-10-30
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: NONE
Current Illness: had had MD exam 2 days prior;
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': TN92142

Write-up: DTP/OPV/HIB/HBV were given 29OCT92 2PM pt found dead 30OCT92 approx 9AM of apparent crib death;


Changed on 5/14/2017

VAERS ID: 47375 Before After
VAERS Form:
Age:0.2
Sex:Male
Location:Tennessee
Vaccinated:1992-10-29
Onset:1992-10-30
Submitted:1992-11-03
Entered:1992-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 322914 / 0 RL / IM
HEP: HEP B (FOREIGN) / MERCK & CO. INC. 1158V / 0 LL / IM
HIBV: HIB (HIBTITER) / LEDERLE PRAXSIS PFIZER/WYETH M155JA / 0 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 0661D / 0 - / PO

Administered by: Public      Purchased by: Public
Symptoms: Lung disorder, Pulmonary oedema, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-10-30
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: NONE
Current Illness: had had MD exam 2 days prior;
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': TN92142

Write-up: DTP/OPV/HIB/HBV were given 29OCT92 2PM pt found dead 30OCT92 approx 9AM of apparent crib death;


Changed on 9/14/2017

VAERS ID: 47375 Before After
VAERS Form:(blank) 1
Age:0.2
Sex:Male
Location:Tennessee
Vaccinated:1992-10-29
Onset:1992-10-30
Submitted:1992-11-03
Entered:1992-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 322914 / 0 1 RL / IM
HEP: HEP B (FOREIGN) / MERCK & CO. INC. 1158V / 0 1 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M155JA / 0 1 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0661D / 0 1 - MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Lung disorder, Pulmonary oedema, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-10-30
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: NONE
Current Illness: had had MD exam 2 days prior;
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': TN92142

Write-up: DTP/OPV/HIB/HBV were given 29OCT92 2PM pt found dead 30OCT92 approx 9AM of apparent crib death;


Changed on 2/14/2018

VAERS ID: 47375 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Tennessee
Vaccinated:1992-10-29
Onset:1992-10-30
Submitted:1992-11-03
Entered:1992-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 322914 / 1 RL / IM
HEP: HEP B (FOREIGN) / MERCK & CO. INC. 1158V / 1 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M155JA / 1 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0661D / 1 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Lung disorder, Pulmonary oedema, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-10-30
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: NONE
Current Illness: had had MD exam 2 days prior;
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': TN92142

Write-up: DTP/OPV/HIB/HBV were given 29OCT92 2PM pt found dead 30OCT92 approx 9AM of apparent crib death;


Changed on 6/14/2018

VAERS ID: 47375 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Tennessee
Vaccinated:1992-10-29
Onset:1992-10-30
Submitted:1992-11-03
Entered:1992-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 322914 / 1 RL / IM
HEP: HEP B (FOREIGN) / MERCK & CO. INC. 1158V / 1 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M155JA / 1 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0661D / 1 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Lung disorder, Pulmonary oedema, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-10-30
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: NONE
Current Illness: had had MD exam 2 days prior;
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': TN92142

Write-up: DTP/OPV/HIB/HBV were given 29OCT92 2PM pt found dead 30OCT92 approx 9AM of apparent crib death;


Changed on 8/14/2018

VAERS ID: 47375 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Tennessee
Vaccinated:1992-10-29
Onset:1992-10-30
Submitted:1992-11-03
Entered:1992-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 322914 / 1 RL / IM
HEP: HEP B (FOREIGN) / MERCK & CO. INC. 1158V / 1 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M155JA / 1 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0661D / 1 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Lung disorder, Pulmonary oedema, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-10-30
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: NONE
Current Illness: had had MD exam 2 days prior;
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': TN92142

Write-up: DTP/OPV/HIB/HBV were given 29OCT92 2PM pt found dead 30OCT92 approx 9AM of apparent crib death;


Changed on 9/14/2018

VAERS ID: 47375 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Tennessee
Vaccinated:1992-10-29
Onset:1992-10-30
Submitted:1992-11-03
Entered:1992-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 322914 / 1 RL / IM
HEP: HEP B (FOREIGN) / MERCK & CO. INC. 1158V / 1 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M155JA / 1 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0661D / 1 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Lung disorder, Pulmonary oedema, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-10-30
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: NONE
Current Illness: had had MD exam 2 days prior;
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': TN92142

Write-up: DTP/OPV/HIB/HBV were given 29OCT92 2PM pt found dead 30OCT92 approx 9AM of apparent crib death;


Changed on 10/14/2018

VAERS ID: 47375 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Tennessee
Vaccinated:1992-10-29
Onset:1992-10-30
Submitted:1992-11-03
Entered:1992-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 322914 / 1 RL / IM
HEP: HEP B (FOREIGN) / MERCK & CO. INC. 1158V / 1 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M155JA / 1 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0661D / 1 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Lung disorder, Pulmonary oedema, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-10-30
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: NONE
Current Illness: had had MD exam 2 days prior;
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': TN92142

Write-up: DTP/OPV/HIB/HBV were given 29OCT92 2PM pt found dead 30OCT92 approx 9AM of apparent crib death;

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=47375&WAYBACKHISTORY=ON


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