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This is VAERS ID 26290

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 26290
VAERS Form:
Age:0.4
Sex:Male
Location:Louisiana
Vaccinated:1990-01-25
Onset:1990-02-03
Submitted:0000-00-00
Entered:1990-10-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 256965 / - - / -
OPV: ORIMUNE / LEDERLE 0592B / - - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: REACT UNEVAL

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-02-03
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: CDC reports: 5 mo infant received DTP/OPV on 25JAN90 and died 3FEB90.


Changed on 12/8/2009

VAERS ID: 26290 Before After
VAERS Form:
Age:0.4
Sex:Male
Location:Louisiana
Vaccinated:1990-01-25
Onset:1990-02-03
Submitted:0000-00-00
Entered:1990-10-23 1990-10-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL DTP (TRI-IMMUNOL) / LEDERLE LEDERLE LABORATORIES 256965 / - - / -
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES 0592B / - - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Unevaluable event, REACT UNEVAL

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-02-03
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) 9001630.01

Write-up: CDC reports: 5 mo infant received DTP/OPV on 25JAN90 and died 3FEB90.


Changed on 5/14/2017

VAERS ID: 26290 Before After
VAERS Form:
Age:0.4
Sex:Male
Location:Louisiana
Vaccinated:1990-01-25
Onset:1990-02-03
Submitted:0000-00-00
Entered:1990-10-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 256965 / - - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 0592B / - - / PO

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-02-03
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': 9001630.01

Write-up: CDC reports: 5 mo infant received DTP/OPV on 25JAN90 and died 3FEB90.


Changed on 9/14/2017

VAERS ID: 26290 Before After
VAERS Form:(blank) 1
Age:0.4
Sex:Male
Location:Louisiana
Vaccinated:1990-01-25
Onset:1990-02-03
Submitted:0000-00-00
Entered:1990-10-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 256965 / - UNK - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0592B / - UNK - MO / PO

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-02-03
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': 9001630.01

Write-up: CDC reports: 5 mo infant received DTP/OPV on 25JAN90 and died 3FEB90.


Changed on 2/14/2018

VAERS ID: 26290 Before After
VAERS Form:1
Age:0.4
Sex:Male
Location:Louisiana
Vaccinated:1990-01-25
Onset:1990-02-03
Submitted:0000-00-00
Entered:1990-10-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 256965 / UNK - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0592B / UNK MO / PO

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-02-03
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': 9001630.01

Write-up: CDC reports: 5 mo infant received DTP/OPV on 25JAN90 and died 3FEB90.


Changed on 6/14/2018

VAERS ID: 26290 Before After
VAERS Form:1
Age:0.4
Sex:Male
Location:Louisiana
Vaccinated:1990-01-25
Onset:1990-02-03
Submitted:0000-00-00
Entered:1990-10-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 256965 / UNK - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0592B / UNK MO / PO

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-02-03
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': 9001630.01

Write-up: CDC reports: 5 mo infant received DTP/OPV on 25JAN90 and died 3FEB90.


Changed on 8/14/2018

VAERS ID: 26290 Before After
VAERS Form:1
Age:0.4
Sex:Male
Location:Louisiana
Vaccinated:1990-01-25
Onset:1990-02-03
Submitted:0000-00-00
Entered:1990-10-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 256965 / UNK - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0592B / UNK MO / PO

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-02-03
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': 9001630.01

Write-up: CDC reports: 5 mo infant received DTP/OPV on 25JAN90 and died 3FEB90.


Changed on 9/14/2018

VAERS ID: 26290 Before After
VAERS Form:1
Age:0.4
Sex:Male
Location:Louisiana
Vaccinated:1990-01-25
Onset:1990-02-03
Submitted:0000-00-00
Entered:1990-10-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 256965 / UNK - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0592B / UNK MO / PO

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-02-03
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': 9001630.01

Write-up: CDC reports: 5 mo infant received DTP/OPV on 25JAN90 and died 3FEB90.


Changed on 10/14/2018

VAERS ID: 26290 Before After
VAERS Form:1
Age:0.4
Sex:Male
Location:Louisiana
Vaccinated:1990-01-25
Onset:1990-02-03
Submitted:0000-00-00
Entered:1990-10-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 256965 / UNK - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0592B / UNK MO / PO

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-02-03
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': 9001630.01

Write-up: CDC reports: 5 mo infant received DTP/OPV on 25JAN90 and died 3FEB90.

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