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From the 4/30/2021 release of VAERS data:

This is VAERS ID 26408



Case Details

VAERS ID: 26408 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Male  
Location: New Jersey  
Vaccinated:1990-10-15
Onset:1990-10-17
   Days after vaccination:2
Submitted: 1990-10-23
   Days after onset:6
Entered: 1990-10-29
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0L11101 / 1 LL / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0615K / 1 MO / PO

Administered by: Private       Purchased by: Private
Symptoms: Pyrexia, Somnolence, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Spinal tap, WBC 800, Lymphs 34, Polys 47, Mono 9, RBC 4, Protein 138.1, Glu 43, L acid 3.1
CDC Split Type:

Write-up: Pt vaccinated with DTP/OPV on 16OCT90 child admitted to hosp w/temp of 104, vomitting & lethargy.


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