National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts.org
Search Results

This is VAERS ID 39932

Government Disclaimer on use of this data

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 39932
VAERS Form:
Age:0.2
Sex:Male
Location:Utah
Vaccinated:1992-02-18
Onset:1992-02-18
Submitted:1992-02-19
Entered:1992-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP / CONNAUGHT LABS 1B31125 / 0 - / IM
HIBV: HIBTITER / LEDERLE(PRAXIS) M160HF / 0 - / IM
OPV: ORIMUNE / LEDERLE 0644C / 0 - / PO

Administered by: Private      Purchased by: Unknown
Symptoms: SIDS, LUNG DIS, PETECHIA, HEM

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-02-18
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:
Other Medications:
Current Illness: NONE
Preexisting Conditions: well baby
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Probable SIDS recvd injections died 3 hrs later;


Changed on 12/8/2009

VAERS ID: 39932 Before After
VAERS Form:
Age:0.2
Sex:Male
Location:Utah
Vaccinated:1992-02-18
Onset:1992-02-18
Submitted:1992-02-19
Entered:1992-03-12 1992-03-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP DTP (NO BRAND NAME) / CONNAUGHT LABS CONNAUGHT LABORATORIES 1B31125 / 0 - / IM
HIBV: HIBTITER HIB (HIBTITER) / LEDERLE(PRAXIS) LEDERLE PRAXSIS M160HF / 0 - / IM
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES 0644C / 0 - / PO

Administered by: Private      Purchased by: Unknown Private
Symptoms: Lung disorder, Petechiae, SIDS, Sudden infant death syndrome, Haemorrhage, LUNG DIS, PETECHIA, HEM

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-02-18
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:
Other Medications:
Current Illness: NONE
Preexisting Conditions: well baby
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) CO4134

Write-up: Probable SIDS recvd injections died 3 hrs later;


Changed on 5/14/2017

VAERS ID: 39932 Before After
VAERS Form:
Age:0.2
Sex:Male
Location:Utah
Vaccinated:1992-02-18
Onset:1992-02-18
Submitted:1992-02-19
Entered:1992-03-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 1B31125 / 0 - / IM
HIBV: HIB (HIBTITER) / LEDERLE PRAXSIS PFIZER/WYETH M160HF / 0 - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 0644C / 0 - / PO

Administered by: Private      Purchased by: Private
Symptoms: Lung disorder, Petechiae, Sudden infant death syndrome, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-02-18
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: NONE
Preexisting Conditions: well baby NONE
Allergies:
Diagnostic Lab Data: Autopsy report pending;
CDC 'Split Type': CO4134 920032201

Write-up: Probable SIDS Pt recvd injections died HIB/OPV/DTP on 18FEB92 & 3 hrs later; later pt died; pt just recently recvd well care check-up which was nl; probable SIDS; autopsy being performed;


Changed on 9/14/2017

VAERS ID: 39932 Before After
VAERS Form:(blank) 1
Age:0.2
Sex:Male
Location:Utah
Vaccinated:1992-02-18
Onset:1992-02-18
Submitted:1992-02-19
Entered:1992-03-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 1B31125 / 0 1 - / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M160HF / 0 1 - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0644C / 0 1 - MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Lung disorder, Petechiae, Sudden infant death syndrome, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-02-18
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: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy report pending;
CDC 'Split Type': 920032201

Write-up: Pt recvd HIB/OPV/DTP on 18FEB92 & 3 hrs later pt died; pt just recently recvd well care check-up which was nl; probable SIDS; autopsy being performed;


Changed on 2/14/2018

VAERS ID: 39932 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Utah
Vaccinated:1992-02-18
Onset:1992-02-18
Submitted:1992-02-19
Entered:1992-03-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 1B31125 / 1 - / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M160HF / 1 - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0644C / 1 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Lung disorder, Petechiae, Sudden infant death syndrome, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-02-18
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: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy report pending;
CDC 'Split Type': 920032201

Write-up: Pt recvd HIB/OPV/DTP on 18FEB92 & 3 hrs later pt died; pt just recently recvd well care check-up which was nl; probable SIDS; autopsy being performed;


Changed on 6/14/2018

VAERS ID: 39932 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Utah
Vaccinated:1992-02-18
Onset:1992-02-18
Submitted:1992-02-19
Entered:1992-03-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 1B31125 / 1 - / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M160HF / 1 - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0644C / 1 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Lung disorder, Petechiae, Sudden infant death syndrome, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-02-18
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: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy report pending;
CDC 'Split Type': 920032201

Write-up: Pt recvd HIB/OPV/DTP on 18FEB92 & 3 hrs later pt died; pt just recently recvd well care check-up which was nl; probable SIDS; autopsy being performed;


Changed on 8/14/2018

VAERS ID: 39932 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Utah
Vaccinated:1992-02-18
Onset:1992-02-18
Submitted:1992-02-19
Entered:1992-03-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 1B31125 / 1 - / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M160HF / 1 - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0644C / 1 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Lung disorder, Petechiae, Sudden infant death syndrome, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-02-18
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: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy report pending;
CDC 'Split Type': 920032201

Write-up: Pt recvd HIB/OPV/DTP on 18FEB92 & 3 hrs later pt died; pt just recently recvd well care check-up which was nl; probable SIDS; autopsy being performed;


Changed on 9/14/2018

VAERS ID: 39932 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Utah
Vaccinated:1992-02-18
Onset:1992-02-18
Submitted:1992-02-19
Entered:1992-03-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 1B31125 / 1 - / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M160HF / 1 - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0644C / 1 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Lung disorder, Petechiae, Sudden infant death syndrome, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-02-18
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: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy report pending;
CDC 'Split Type': 920032201

Write-up: Pt recvd HIB/OPV/DTP on 18FEB92 & 3 hrs later pt died; pt just recently recvd well care check-up which was nl; probable SIDS; autopsy being performed;


Changed on 10/14/2018

VAERS ID: 39932 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Utah
Vaccinated:1992-02-18
Onset:1992-02-18
Submitted:1992-02-19
Entered:1992-03-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 1B31125 / 1 - / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M160HF / 1 - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0644C / 1 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Lung disorder, Petechiae, Sudden infant death syndrome, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-02-18
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: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy report pending;
CDC 'Split Type': 920032201

Write-up: Pt recvd HIB/OPV/DTP on 18FEB92 & 3 hrs later pt died; pt just recently recvd well care check-up which was nl; probable SIDS; autopsy being performed;


Changed on 12/24/2020

VAERS ID: 39932 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Utah
Vaccinated:1992-02-18
Onset:1992-02-18
Submitted:1992-02-19
Entered:1992-03-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 1B31125 / 1 - / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M160HF / 1 - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0644C / 1 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Lung disorder, Petechiae, Sudden infant death syndrome, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-02-18
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: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy report pending;
CDC 'Split Type': 920032201

Write-up: Pt recvd HIB/OPV/DTP on 18FEB92 & 3 hrs later pt died; pt just recently recvd well care check-up which was nl; probable SIDS; autopsy being performed;


Changed on 12/30/2020

VAERS ID: 39932 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Utah
Vaccinated:1992-02-18
Onset:1992-02-18
Submitted:1992-02-19
Entered:1992-03-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 1B31125 / 1 - / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M160HF / 1 - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0644C / 1 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Lung disorder, Petechiae, Sudden infant death syndrome, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-02-18
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: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy report pending;
CDC 'Split Type': 920032201

Write-up: Pt recvd HIB/OPV/DTP on 18FEB92 & 3 hrs later pt died; pt just recently recvd well care check-up which was nl; probable SIDS; autopsy being performed;


Changed on 5/7/2021

VAERS ID: 39932 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Utah
Vaccinated:1992-02-18
Onset:1992-02-18
Submitted:1992-02-19
Entered:1992-03-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 1B31125 / 1 - / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M160HF / 1 - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0644C / 1 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Lung disorder, Petechiae, Sudden infant death syndrome, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-02-18
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: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy report pending;
CDC 'Split Type': 920032201

Write-up: Pt recvd HIB/OPV/DTP on 18FEB92 & 3 hrs later pt died; pt just recently recvd well care check-up which was nl; probable SIDS; autopsy being performed;


Changed on 5/21/2021

VAERS ID: 39932 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Utah
Vaccinated:1992-02-18
Onset:1992-02-18
Submitted:1992-02-19
Entered:1992-03-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 1B31125 / 1 - / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M160HF / 1 - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0644C / 1 MO / PO

Administered by: Private      Purchased by: Private
Symptoms: Lung disorder, Petechiae, Sudden infant death syndrome, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-02-18
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: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy report pending;
CDC 'Split Type': 920032201

Write-up: Pt recvd HIB/OPV/DTP on 18FEB92 & 3 hrs later pt died; pt just recently recvd well care check-up which was nl; probable SIDS; autopsy being performed;

New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=39932&WAYBACKHISTORY=ON


Copyright © 2022 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166