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This is VAERS ID 27153

(NOTE: This result is from the 6/14/2018 version of the VAERS database)

Case Details

VAERS ID: 27153 (history)  
Form: Version 1.0  
Age: 0.3  
Sex: Unknown  
Location: Ohio  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 1990-12-05
Entered: 1990-12-21
   Days after submission:16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0B21173 / UNK - / -
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH - / UNK MO / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Sudden infant death syndrome
SMQs:, Neonatal disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
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: CO3729

Write-up: Pt vaccinated with DTP/OPV/HIB; SIDS death 1 day post injection.


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20180614&IDNUMBER=27153


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