From the 5/14/2017 release of VAERS data (an older release, current is 1/7/2021):

This is VAERS ID 25026

Case Details

VAERS ID:	25026 (history)
Form:	Version .0
Age:	1.0
Sex:	Male
Location:	Washington

Vaccinated:	1990-01-12
Onset:	1990-01-14
Days after vaccination:	2
Submitted:	0000-00-00
Entered:	1990-07-09

Vaccination / Manufacturer	Lot / Dose	Site / Route
DT: DT ADSORBED (NO BRAND NAME) / LEDERLE LABORATORIES	229974 / -	- / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES	9A11092 / -	- / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH	244970 / -	- / PO

Administered by: Unknown Purchased by: Unknown
Symptoms: Unevaluable event
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 1990-01-14
Days after onset: 0
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:

Write-up: child found dead in bed 14Jan90. Had full check up 12Jan90 with immunizations DPT/HIB/Oral Polio

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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20170514&IDNUMBER=25026