National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 28432

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 28432
VAERS Form:
Age:0.3
Sex:Male
Location:Connecticut
Vaccinated:1991-01-15
Onset:1991-01-15
Submitted:0000-00-00
Entered:1991-03-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 293948 / 1 LL / IM
HIBV: HIBTITER / LEDERLE(PRAXIS) M090FF / 0 RL / IM
OPV: ORIMUNE / LEDERLE 287942 / 0 - / PO

Administered by: Public      Purchased by: Unknown
Symptoms: INFECT, APNEA, EDEMA LUNG, HEART ARREST, ABDO ENLARGE

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1991-01-15
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: no
Other Medications: synthroid
Current Illness: hypothyroidism, cranialsynostosis, herni
Preexisting Conditions: hypothyroidism, cranialsynostosis, hernia repair X 2, bronchopulmanary dysplasia
Allergies:
Diagnostic Lab Data: blood drawn post immun-all normal, blood drawn in ER possible for alpha strep
CDC 'Split Type': hypothyroidism, cranialsynostosis, hernia repair X 2, bronchopulmanary dysplasia

Write-up: pulmonary congestion & edema,bronchopulmonary dysplasia, Child not acting right all day, as per family, stopped breathing in front of mom, found in cardiac arrest by EMT who began CPR,pt found /w distended abdomen, decompressed manually


Changed on 12/8/2009

VAERS ID: 28432 Before After
VAERS Form:
Age:0.3
Sex:Male
Location:Connecticut
Vaccinated:1991-01-15
Onset:1991-01-15
Submitted:0000-00-00
Entered:1991-03-04 1991-02-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL DTP (TRI-IMMUNOL) / LEDERLE LEDERLE LABORATORIES 293948 / 1 LL / IM
HIBV: HIBTITER HIB (HIBTITER) / LEDERLE(PRAXIS) LEDERLE PRAXSIS M090FF / 0 RL / IM
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES 287942 / 0 - / PO

Administered by: Public      Purchased by: Unknown Public
Symptoms: Abdominal distension, Apnoea, Cardiac arrest, Infection, Lung disorder, Personality disorder, Pulmonary oedema, INFECT, APNEA, EDEMA LUNG, HEART ARREST, ABDO ENLARGE

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1991-01-15
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: no
Other Medications: synthroid
Current Illness: hypothyroidism, cranialsynostosis, herni
Preexisting Conditions: hypothyroidism, cranialsynostosis, hernia repair X 2, bronchopulmanary dysplasia
Allergies:
Diagnostic Lab Data: blood drawn post immun-all normal, blood drawn in ER possible for alpha strep
CDC 'Split Type': hypothyroidism, cranialsynostosis, hernia repair X 2, bronchopulmanary dysplasia CT911

Write-up: pulmonary congestion & edema,bronchopulmonary dysplasia, Child not acting right all day, as per family, stopped breathing in front of mom, found in cardiac arrest by EMT who began CPR,pt found /w distended abdomen, decompressed manually


Changed on 5/14/2017

VAERS ID: 28432 Before After
VAERS Form:
Age:0.3
Sex:Male
Location:Connecticut
Vaccinated:1991-01-15
Onset:1991-01-15
Submitted:0000-00-00
Entered:1991-02-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 293948 / 1 LL / IM
HIBV: HIB (HIBTITER) / LEDERLE PRAXSIS PFIZER/WYETH M090FF / 0 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 287942 / 0 - / PO

Administered by: Public      Purchased by: Public
Symptoms: Abdominal distension, Apnoea, Cardiac arrest, Infection, Lung disorder, Personality disorder, Pulmonary oedema

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1991-01-15
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: no no~ ()~~~In patient
Other Medications: synthroid
Current Illness: hypothyroidism, cranialsynostosis, herni
Preexisting Conditions: hypothyroidism, cranialsynostosis, hernia repair X 2, bronchopulmanary dysplasia
Allergies:
Diagnostic Lab Data: blood drawn post immun-all normal, blood drawn in ER possible for alpha strep
CDC 'Split Type': CT911

Write-up: pulmonary congestion & edema,bronchopulmonary dysplasia, Child not acting right all day, as per family, stopped breathing in front of mom, found in cardiac arrest by EMT who began CPR,pt found /w distended abdomen, decompressed manually


Changed on 9/14/2017

VAERS ID: 28432 Before After
VAERS Form:(blank) 1
Age:0.3
Sex:Male
Location:Connecticut
Vaccinated:1991-01-15
Onset:1991-01-15
Submitted:0000-00-00
Entered:1991-02-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 293948 / 1 2 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M090FF / 0 1 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 287942 / 0 1 - MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Abdominal distension, Apnoea, Cardiac arrest, Infection, Lung disorder, Personality disorder, Pulmonary oedema

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1991-01-15
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: no~ ()~~~In patient
Other Medications: synthroid
Current Illness: hypothyroidism, cranialsynostosis, herni
Preexisting Conditions: hypothyroidism, cranialsynostosis, hernia repair X 2, bronchopulmanary dysplasia
Allergies:
Diagnostic Lab Data: blood drawn post immun-all normal, blood drawn in ER possible for alpha strep
CDC 'Split Type': CT911

Write-up: pulmonary congestion & edema,bronchopulmonary dysplasia, Child not acting right all day, as per family, stopped breathing in front of mom, found in cardiac arrest by EMT who began CPR,pt found /w distended abdomen, decompressed manually


Changed on 2/14/2018

VAERS ID: 28432 Before After
VAERS Form:1
Age:0.3
Sex:Male
Location:Connecticut
Vaccinated:1991-01-15
Onset:1991-01-15
Submitted:0000-00-00
Entered:1991-02-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 293948 / 2 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M090FF / 1 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 287942 / 1 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Abdominal distension, Apnoea, Cardiac arrest, Infection, Lung disorder, Personality disorder, Pulmonary oedema

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1991-01-15
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: no~ ()~~~In patient
Other Medications: synthroid
Current Illness: hypothyroidism, cranialsynostosis, herni
Preexisting Conditions: hypothyroidism, cranialsynostosis, hernia repair X 2, bronchopulmanary dysplasia
Allergies:
Diagnostic Lab Data: blood drawn post immun-all normal, blood drawn in ER possible for alpha strep
CDC 'Split Type': CT911

Write-up: pulmonary congestion & edema,bronchopulmonary dysplasia, Child not acting right all day, as per family, stopped breathing in front of mom, found in cardiac arrest by EMT who began CPR,pt found /w distended abdomen, decompressed manually


Changed on 6/14/2018

VAERS ID: 28432 Before After
VAERS Form:1
Age:0.3
Sex:Male
Location:Connecticut
Vaccinated:1991-01-15
Onset:1991-01-15
Submitted:0000-00-00
Entered:1991-02-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 293948 / 2 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M090FF / 1 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 287942 / 1 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Abdominal distension, Apnoea, Cardiac arrest, Infection, Lung disorder, Personality disorder, Pulmonary oedema

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1991-01-15
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: no~ ()~~~In patient
Other Medications: synthroid
Current Illness: hypothyroidism, cranialsynostosis, herni
Preexisting Conditions: hypothyroidism, cranialsynostosis, hernia repair X 2, bronchopulmanary dysplasia
Allergies:
Diagnostic Lab Data: blood drawn post immun-all normal, blood drawn in ER possible for alpha strep
CDC 'Split Type': CT911

Write-up: pulmonary congestion & edema,bronchopulmonary dysplasia, Child not acting right all day, as per family, stopped breathing in front of mom, found in cardiac arrest by EMT who began CPR,pt found /w distended abdomen, decompressed manually


Changed on 8/14/2018

VAERS ID: 28432 Before After
VAERS Form:1
Age:0.3
Sex:Male
Location:Connecticut
Vaccinated:1991-01-15
Onset:1991-01-15
Submitted:0000-00-00
Entered:1991-02-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 293948 / 2 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M090FF / 1 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 287942 / 1 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Abdominal distension, Apnoea, Cardiac arrest, Infection, Lung disorder, Personality disorder, Pulmonary oedema

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1991-01-15
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: no~ ()~~~In patient
Other Medications: synthroid
Current Illness: hypothyroidism, cranialsynostosis, herni
Preexisting Conditions: hypothyroidism, cranialsynostosis, hernia repair X 2, bronchopulmanary dysplasia
Allergies:
Diagnostic Lab Data: blood drawn post immun-all normal, blood drawn in ER possible for alpha strep
CDC 'Split Type': CT911

Write-up: pulmonary congestion & edema,bronchopulmonary dysplasia, Child not acting right all day, as per family, stopped breathing in front of mom, found in cardiac arrest by EMT who began CPR,pt found /w distended abdomen, decompressed manually


Changed on 9/14/2018

VAERS ID: 28432 Before After
VAERS Form:1
Age:0.3
Sex:Male
Location:Connecticut
Vaccinated:1991-01-15
Onset:1991-01-15
Submitted:0000-00-00
Entered:1991-02-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 293948 / 2 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M090FF / 1 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 287942 / 1 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Abdominal distension, Apnoea, Cardiac arrest, Infection, Lung disorder, Personality disorder, Pulmonary oedema

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1991-01-15
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: no~ ()~~~In patient
Other Medications: synthroid
Current Illness: hypothyroidism, cranialsynostosis, herni
Preexisting Conditions: hypothyroidism, cranialsynostosis, hernia repair X 2, bronchopulmanary dysplasia
Allergies:
Diagnostic Lab Data: blood drawn post immun-all normal, blood drawn in ER possible for alpha strep
CDC 'Split Type': CT911

Write-up: pulmonary congestion & edema,bronchopulmonary dysplasia, Child not acting right all day, as per family, stopped breathing in front of mom, found in cardiac arrest by EMT who began CPR,pt found /w distended abdomen, decompressed manually


Changed on 10/14/2018

VAERS ID: 28432 Before After
VAERS Form:1
Age:0.3
Sex:Male
Location:Connecticut
Vaccinated:1991-01-15
Onset:1991-01-15
Submitted:0000-00-00
Entered:1991-02-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 293948 / 2 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M090FF / 1 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 287942 / 1 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Abdominal distension, Apnoea, Cardiac arrest, Infection, Lung disorder, Personality disorder, Pulmonary oedema

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1991-01-15
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: no~ ()~~~In patient
Other Medications: synthroid
Current Illness: hypothyroidism, cranialsynostosis, herni
Preexisting Conditions: hypothyroidism, cranialsynostosis, hernia repair X 2, bronchopulmanary dysplasia
Allergies:
Diagnostic Lab Data: blood drawn post immun-all normal, blood drawn in ER possible for alpha strep
CDC 'Split Type': CT911

Write-up: pulmonary congestion & edema,bronchopulmonary dysplasia, Child not acting right all day, as per family, stopped breathing in front of mom, found in cardiac arrest by EMT who began CPR,pt found /w distended abdomen, decompressed manually

New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=28432&WAYBACKHISTORY=ON


Copyright © 2019 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166