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This is VAERS ID 30244

Case Details

VAERS ID: 30244 (history)  
Form: Version 1.0  
Age: 0.3  
Sex: Female  
Location: Ohio  
Vaccinated:1990-11-28
Onset:1990-11-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 1991-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES - / 2 - / -
HIBV: HIB (HIBTITER) / PFIZER/WYETH M205FD / 1 - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH - / 2 MO / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Apnoea, Cardiac arrest, Cyanosis, Sudden infant death syndrome
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (narrow), Cardiomyopathy (broad), Neonatal disorders (narrow), Hypotonic-hyporesponsive episode (broad), Respiratory failure (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1990-11-29
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: no problems with 1st DTP & OPV~ ()~~~In patient
Other Medications: APAP
Current Illness:
Preexisting Conditions: No chronic illnesses
Allergies:
Diagnostic Lab Data: Autopsy Report 30NOV90 available-cause of death: SIDS
CDC Split Type: 900216701

Write-up: Morning p/immun, infant was found dead in her crib by babysitter, infant was blue, pulseless & apneic; transported by Ambulance to ER & pronounced dead; Cause-SIDS no sx to immun as fever or irritability, appeared healthy;


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