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From the 1/7/2022 release of VAERS data:

This is VAERS ID 40527

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Case Details

VAERS ID: 40527 (history)  
Form: Version 1.0  
Age: 0.3  
Sex: Male  
Location: Washington  
Vaccinated:1991-12-16
Onset:1991-12-16
   Days after vaccination:0
Submitted: 1992-01-06
   Days after onset:21
Entered: 1992-03-23
   Days after submission:77
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 306924 / 2 RL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M680HE / 2 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 308957 / 2 MO / PO

Administered by: Private       Purchased by: Public
Symptoms: Atelectasis, Haemorrhage, Hepatocellular damage, Lymphadenopathy, Petechiae, Pulmonary oedema, Spleen disorder, Sudden infant death syndrome
SMQs:, Cardiac failure (narrow), Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Neonatal disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1991-12-16
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type: WA92673

Write-up: SIDS found dead in crib;


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