National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 29431

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 29431
VAERS Form:
Age:0.2
Sex:Male
Location:Illinois
Vaccinated:1991-03-15
Onset:1991-03-21
Submitted:1991-03-22
Entered:1991-04-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP / CONNAUGHT LABS 0C21045 / 0 - / IM
HIBV: HIBTITER / LEDERLE(PRAXIS) M660FP / 0 - / IM
OPV: ORIMUNE / LEDERLE 295948 / 0 - / PO

Administered by: Private      Purchased by: Unknown
Symptoms: SIDS, HEART ARREST

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1991-03-21
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: none
Other Medications: none
Current Illness: prior 2-3 wks bronchitis-now over
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: autopsy -SIDS
CDC 'Split Type': none

Write-up: Sudden arrest /p feeding @ baby sitters. DOA 6 days /p vaxs. Baby was fine before, mother went to work. With baby sitter. Autopsy prelim DX-SIDS death, no abnormalities found


Changed on 12/8/2009

VAERS ID: 29431 Before After
VAERS Form:
Age:0.2
Sex:Male
Location:Illinois
Vaccinated:1991-03-15
Onset:1991-03-21
Submitted:1991-03-22
Entered:1991-04-03 1991-03-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP DTP (NO BRAND NAME) / CONNAUGHT LABS CONNAUGHT LABORATORIES 0C21045 / 0 - / IM
HIBV: HIBTITER HIB (HIBTITER) / LEDERLE(PRAXIS) LEDERLE PRAXSIS M660FP / 0 - / IM
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES 295948 / 0 - / PO

Administered by: Private      Purchased by: Unknown Private
Symptoms: Cardiac arrest, SIDS, Sudden infant death syndrome, HEART ARREST

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1991-03-21
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: none
Other Medications: none
Current Illness: prior 2-3 wks bronchitis-now over
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: autopsy -SIDS
CDC 'Split Type': none (blank)

Write-up: Sudden arrest /p feeding @ baby sitters. DOA 6 days /p vaxs. Baby was fine before, mother went to work. With baby sitter. Autopsy prelim DX-SIDS death, no abnormalities found


Changed on 5/14/2017

VAERS ID: 29431 Before After
VAERS Form:
Age:0.2
Sex:Male
Location:Illinois
Vaccinated:1991-03-15
Onset:1991-03-21
Submitted:1991-03-22
Entered:1991-03-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0C21045 / 0 - / IM
HIBV: HIB (HIBTITER) / LEDERLE PRAXSIS PFIZER/WYETH M660FP / 0 - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 295948 / 0 - / PO

Administered by: Private      Purchased by: Private
Symptoms: Cardiac arrest, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1991-03-21
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: none none~ ()~~~In patient
Other Medications: none
Current Illness: prior 2-3 wks bronchitis-now over
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: autopsy -SIDS
CDC 'Split Type':

Write-up: Sudden arrest /p feeding @ baby sitters. DOA 6 days /p vaxs. Baby was fine before, mother went to work. With baby sitter. Autopsy prelim DX-SIDS death, no abnormalities found


Changed on 9/14/2017

VAERS ID: 29431 Before After
VAERS Form:(blank) 1
Age:0.2
Sex:Male
Location:Illinois
Vaccinated:1991-03-15
Onset:1991-03-21
Submitted:1991-03-22
Entered:1991-03-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0C21045 / 0 1 - / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M660FP / 0 1 - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 295948 / 0 1 - MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Cardiac arrest, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1991-03-21
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: none~ ()~~~In patient
Other Medications: none
Current Illness: prior 2-3 wks bronchitis-now over
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: autopsy -SIDS
CDC 'Split Type':

Write-up: Sudden arrest /p feeding @ baby sitters. DOA 6 days /p vaxs. Baby was fine before, mother went to work. With baby sitter. Autopsy prelim DX-SIDS death, no abnormalities found


Changed on 2/14/2018

VAERS ID: 29431 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Illinois
Vaccinated:1991-03-15
Onset:1991-03-21
Submitted:1991-03-22
Entered:1991-03-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0C21045 / 1 - / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M660FP / 1 - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 295948 / 1 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Cardiac arrest, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1991-03-21
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: none~ ()~~~In patient
Other Medications: none
Current Illness: prior 2-3 wks bronchitis-now over
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: autopsy -SIDS
CDC 'Split Type':

Write-up: Sudden arrest /p feeding @ baby sitters. DOA 6 days /p vaxs. Baby was fine before, mother went to work. With baby sitter. Autopsy prelim DX-SIDS death, no abnormalities found


Changed on 6/14/2018

VAERS ID: 29431 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Illinois
Vaccinated:1991-03-15
Onset:1991-03-21
Submitted:1991-03-22
Entered:1991-03-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0C21045 / 1 - / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M660FP / 1 - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 295948 / 1 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Cardiac arrest, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1991-03-21
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: none~ ()~~~In patient
Other Medications: none
Current Illness: prior 2-3 wks bronchitis-now over
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: autopsy -SIDS
CDC 'Split Type':

Write-up: Sudden arrest /p feeding @ baby sitters. DOA 6 days /p vaxs. Baby was fine before, mother went to work. With baby sitter. Autopsy prelim DX-SIDS death, no abnormalities found


Changed on 8/14/2018

VAERS ID: 29431 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Illinois
Vaccinated:1991-03-15
Onset:1991-03-21
Submitted:1991-03-22
Entered:1991-03-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0C21045 / 1 - / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M660FP / 1 - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 295948 / 1 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Cardiac arrest, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1991-03-21
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: none~ ()~~~In patient
Other Medications: none
Current Illness: prior 2-3 wks bronchitis-now over
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: autopsy -SIDS
CDC 'Split Type':

Write-up: Sudden arrest /p feeding @ baby sitters. DOA 6 days /p vaxs. Baby was fine before, mother went to work. With baby sitter. Autopsy prelim DX-SIDS death, no abnormalities found


Changed on 9/14/2018

VAERS ID: 29431 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Illinois
Vaccinated:1991-03-15
Onset:1991-03-21
Submitted:1991-03-22
Entered:1991-03-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0C21045 / 1 - / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M660FP / 1 - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 295948 / 1 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Cardiac arrest, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1991-03-21
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: none~ ()~~~In patient
Other Medications: none
Current Illness: prior 2-3 wks bronchitis-now over
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: autopsy -SIDS
CDC 'Split Type':

Write-up: Sudden arrest /p feeding @ baby sitters. DOA 6 days /p vaxs. Baby was fine before, mother went to work. With baby sitter. Autopsy prelim DX-SIDS death, no abnormalities found


Changed on 10/14/2018

VAERS ID: 29431 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Illinois
Vaccinated:1991-03-15
Onset:1991-03-21
Submitted:1991-03-22
Entered:1991-03-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0C21045 / 1 - / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M660FP / 1 - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 295948 / 1 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Cardiac arrest, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1991-03-21
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: none~ ()~~~In patient
Other Medications: none
Current Illness: prior 2-3 wks bronchitis-now over
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: autopsy -SIDS
CDC 'Split Type':

Write-up: Sudden arrest /p feeding @ baby sitters. DOA 6 days /p vaxs. Baby was fine before, mother went to work. With baby sitter. Autopsy prelim DX-SIDS death, no abnormalities found

New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=29431&WAYBACKHISTORY=ON


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