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This is VAERS ID 26973

(NOTE: This result is from the 12/31/2003 version of the VAERS database)

Case Details

VAERS ID: 26973 (history)  
Form: Version .0  
Age: 3.6  
Sex: Female  
Location: California  
Vaccinated:1990-07-17
Onset:1990-07-28
   Days after vaccination:11
Submitted: 1990-11-20
   Days after onset:115
Entered: 1990-12-14
   Days after submission:24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: PROHIBIT / CONNAUGHT LABS 9B11095 / 0 LA / -
OPV: ORIMUNE / LEDERLE 275910 / 2 - / PO

Administered by: Public       Purchased by: Unknown
Symptoms: ACIDOSIS, APNEA, BRONCHIOLITIS, CONVULS GRAND MAL, HEART ARREST
SMQs:

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 1990-07-28
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt vaccinated with TOPV/HIB It is not known if pt''s illness was in any way related to previous vaccinations. Death cert states: bronchiolitis w/focal early bronchial pneumonia.


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=26973


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